Provider Demographics
NPI:1770653529
Name:CARPENTER, DONALD H (LMT, NCTMBP)
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:H
Last Name:CARPENTER
Suffix:
Gender:M
Credentials:LMT, NCTMBP
Other - Prefix:
Other - First Name:DON
Other - Middle Name:
Other - Last Name:CARPENTER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMT, NCTMBP
Mailing Address - Street 1:701 W POINSETT ST
Mailing Address - Street 2:
Mailing Address - City:GREER
Mailing Address - State:SC
Mailing Address - Zip Code:29650-1451
Mailing Address - Country:US
Mailing Address - Phone:864-848-1232
Mailing Address - Fax:864-989-0106
Practice Address - Street 1:701 W POINSETT ST
Practice Address - Street 2:
Practice Address - City:GREER
Practice Address - State:SC
Practice Address - Zip Code:29650
Practice Address - Country:US
Practice Address - Phone:864-848-1232
Practice Address - Fax:864-989-0106
Is Sole Proprietor?:No
Enumeration Date:2006-11-09
Last Update Date:2018-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC28522081N0008X, 171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor
No2081N0008XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationNeuromuscular Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC2852OtherSC LMT