Provider Demographics
NPI:1669463030
Name:PRICE, CAROLINE ROBERTS (MD)
Entity Type:Individual
Prefix:MS
First Name:CAROLINE
Middle Name:ROBERTS
Last Name:PRICE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:10 ENTERPRISE BLVD
Mailing Address - Street 2:STE 207
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29615-3554
Mailing Address - Country:US
Mailing Address - Phone:864-331-2505
Mailing Address - Fax:864-331-2510
Practice Address - Street 1:10 ENTERPRISE BLVD
Practice Address - Street 2:STE 207
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29615-3554
Practice Address - Country:US
Practice Address - Phone:864-331-2505
Practice Address - Fax:864-331-2510
Is Sole Proprietor?:No
Enumeration Date:2005-11-03
Last Update Date:2016-10-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SC22781207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
H17490Medicare UPIN
H174907407Medicare ID - Type Unspecified