Provider Demographics
NPI:1932116217
Name:ALAN, CAROL B (MD)
Entity Type:Individual
Prefix:DR
First Name:CAROL
Middle Name:B
Last Name:ALAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:CAROL
Other - Middle Name:L
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 743904
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-3904
Mailing Address - Country:US
Mailing Address - Phone:803-296-7320
Mailing Address - Fax:
Practice Address - Street 1:2 MEDICAL PARK RD STE 107
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29203-6839
Practice Address - Country:US
Practice Address - Phone:803-434-4480
Practice Address - Fax:803-434-3340
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2021-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC22469207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCCBP031Medicaid
SC372048Medicaid
SC7124OtherMEDICARE ID
SCH482427124Medicare PIN
H48242Medicare UPIN