Provider Demographics
NPI:1528233012
Name:CAROLINA MEDICINE, P.C.
Entity Type:Organization
Organization Name:CAROLINA MEDICINE, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:ANDREA
Authorized Official - Last Name:WHITTEN
Authorized Official - Suffix:
Authorized Official - Credentials:PA-C
Authorized Official - Phone:919-718-5705
Mailing Address - Street 1:310 COURT SQUARE
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:NC
Mailing Address - Zip Code:27330-5657
Mailing Address - Country:US
Mailing Address - Phone:919-718-5707
Mailing Address - Fax:919-777-7248
Practice Address - Street 1:310 COURT SQUARE
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:NC
Practice Address - Zip Code:27330-5657
Practice Address - Country:US
Practice Address - Phone:919-718-5707
Practice Address - Fax:919-777-7248
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-25
Last Update Date:2008-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200301154261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care