Provider Demographics
NPI:1699861096
Name:AMES, CAROLINE DOROTHEA (MD)
Entity type:Individual
Prefix:DR
First Name:CAROLINE
Middle Name:DOROTHEA
Last Name:AMES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:CAROLINE
Other - Middle Name:DOROTHEA
Other - Last Name:RYAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:275 BETHESDA DR
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27834-7217
Mailing Address - Country:US
Mailing Address - Phone:252-752-5077
Mailing Address - Fax:252-752-9544
Practice Address - Street 1:275 BETHESDA DR
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-7217
Practice Address - Country:US
Practice Address - Phone:252-752-5077
Practice Address - Fax:252-752-9544
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2022-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200700994208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5907894Medicaid
NC147U8OtherBCBSNC
NC201979OtherMEDCOST
NC0926658OtherCIGNA
NC2073097Medicare PIN