MEDICARE: DR. KIMBERLY CARTER MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	66461	GA

General Provider Information

NPI Number	:	1043367840
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KIMBERLY CARTER MD

Provider Business Mailing Address
First Line	:	2516 RIVER HEIGHTS CIR
Second Line	:
City	:	LOGANVILLE
State	:	GA
Zip	:	30052-6312
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2516 RIVER HEIGHTS CIR
Second Line	:
City	:	LOGANVILLE
State	:	GA
Zip	:	30052-6312
Country	:	US
Telephone Number	:	470-462-7874
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/04/2007
Last Update Date	:	04/29/2026

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