| Organization Name: | SHOCKWAVE SPECIALISTS OF THE CAROLINAS LLC |
| NPI Number: | 1063446961 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | M FILMORE HODNETT (BUSINESS MANAGER) |
| Mailing Address: | 705 Griffith St Ste 205 Davidson |
| State: | NC US |
| Postal Code: | 28036 |
| Phone Number: | 7048971024 |
| Fax Number: | 7048972033 |
| NPI Enumeration Date: | 07/10/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 213ES0103X |
| License Number: | 00000 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NC |
| Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
| Taxonomy Classification: | Podiatrist |
| Taxonomy Specialization: | Foot & Ankle Surgery |
| Taxonomy Definition: | |