MEDICARE: THE CARTER CLINIC

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	261QM0850X	Adult Mental Health Clinic/Center

General Provider Information

NPI Number	:	1871813931
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE CARTER CLINIC

Provider Business Mailing Address
First Line	:	210 SOUTH CLINTON AVENUE
Second Line	:
City	:	DUNN
State	:	NC
Zip	:	28334-4907
Country	:	US
Telephone Number	:	910-797-6511
Fax Number	:

Provider Business Practice Location Address
First Line	:	210 SOUTH CLINTON AVENUE
Second Line	:
City	:	DUNN
State	:	NC
Zip	:	28334-4907
Country	:	US
Telephone Number	:	910-797-6511
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MYLEME O HARRISON
Credential	:	MD
Telephone Number	:	910-797-6511

Provider Enumeration Date	:	06/10/2010
Last Update Date	:	06/10/2010

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Directions to “THE CARTER CLINIC ” Practice Location

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