Provider Demographics
NPI:1407952112
Name:KARAGEORGIOU, CAROLYN Z (MPH, RD, LD)
Entity Type:Individual
Prefix:
First Name:CAROLYN
Middle Name:Z
Last Name:KARAGEORGIOU
Suffix:
Gender:F
Credentials:MPH, RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 UNIVERSITY RDG
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29601-3635
Mailing Address - Country:US
Mailing Address - Phone:864-372-3071
Mailing Address - Fax:864-282-4394
Practice Address - Street 1:200 UNIVERSITY RDG
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29601-3635
Practice Address - Country:US
Practice Address - Phone:864-372-3071
Practice Address - Fax:864-282-4394
Is Sole Proprietor?:No
Enumeration Date:2006-09-16
Last Update Date:2014-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC150133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC150OtherLICENSED DIETITIAN
SC576000286OtherSC DEPARTMENT OF HEALTH AND ENVIRONMENTAL CONTROL
RD 383908OtherLICENSE #
SCQ34109Medicare UPIN
RD 383908OtherLICENSE #