Provider Demographics
NPI:1386441715
Name:CAROLINA ADVANCED WOUND CARE LLC
Entity type:Organization
Organization Name:CAROLINA ADVANCED WOUND CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:R
Authorized Official - Last Name:DONATO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:803-422-6819
Mailing Address - Street 1:116 MATCH POINT DR
Mailing Address - Street 2:
Mailing Address - City:CHAPIN
Mailing Address - State:SC
Mailing Address - Zip Code:29036-7878
Mailing Address - Country:US
Mailing Address - Phone:803-422-6819
Mailing Address - Fax:866-902-0669
Practice Address - Street 1:116 MATCH POINT DR
Practice Address - Street 2:
Practice Address - City:CHAPIN
Practice Address - State:SC
Practice Address - Zip Code:29036-7878
Practice Address - Country:US
Practice Address - Phone:803-422-6819
Practice Address - Fax:866-902-0669
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-25
Last Update Date:2025-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty