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Contact Information

CAROL A KOOISTRA, MD
541 FLOYD RD
SPARTANBURG, SC29307-1520
 Phone: 864-585-6179
 Fax: 864-583-5403
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Neurology

2084N0400X 13 Physician/Neurology
Indicates primary specialty

NPI Profile & details for CAROL A KOOISTRA · (Female)

NPI # 1598741837
Status Active
Credentials MD
Entity Individual
Enumeration date 12/19/2005
Last updated 02/13/2011 - About 15 years ago
Sole proprietor 1 Yes
Identifiers
  • SC License # 13349
  • NC Medicaid 89135C9
  • Other 135C9 BCBS
  • NC Other P00316714 MEDICARE RR
  • NC Other B91448 UPIN
Hospital affiliation(s)
  • SPARTANBURG REGIONAL MEDICAL CENTER - (Acute Care)
    101 E WOOD ST
    SPARTANBURG, SC 29303
  • UPSTATE CAROLINA MEDICAL CENTER - (Acute Care)
    1530 N LIMESTONE ST
    GAFFNEY, SC 29340
  • VILLAGE HOSPITAL - (Acute Care)
    250 WESTMORELAND ROAD
    GREER, SC 29651
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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