Provider Demographics
NPI:1679562805
Name:CAROLINA LUNG ASSOCIATES, PA
Entity Type:Organization
Organization Name:CAROLINA LUNG ASSOCIATES, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:SHEA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-763-3360
Mailing Address - Street 1:2097 HENRY TECKLENBURG DR
Mailing Address - Street 2:STE 305
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29414-5740
Mailing Address - Country:US
Mailing Address - Phone:843-763-3360
Mailing Address - Fax:843-763-3038
Practice Address - Street 1:2097 HENRY TECKLENBURG DR
Practice Address - Street 2:STE 305
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29414-5740
Practice Address - Country:US
Practice Address - Phone:843-763-3360
Practice Address - Fax:843-763-3038
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care MedicineGroup - Multi-Specialty
Not Answered207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty