Provider Demographics
NPI:1487889200
Name:CAROLINA FOOT & ANKLE SPECIALISTS, LLC
Entity type:Organization
Organization Name:CAROLINA FOOT & ANKLE SPECIALISTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PODIATRIST/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:CRAIG
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:843-225-5575
Mailing Address - Street 1:501 BRAMSON CT UNIT 301
Mailing Address - Street 2:
Mailing Address - City:MT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464-7953
Mailing Address - Country:US
Mailing Address - Phone:843-654-8250
Mailing Address - Fax:843-654-8253
Practice Address - Street 1:501 BRAMSON CT UNIT 301
Practice Address - Street 2:
Practice Address - City:MT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-7953
Practice Address - Country:US
Practice Address - Phone:843-225-5575
Practice Address - Fax:843-225-5515
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-22
Last Update Date:2024-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC550213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCPD5453Medicaid
SC4512630002Medicare NSC
SC7295Medicare PIN