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NPI Code Detail

MEDICARE: SHANTAE CARTER

MEDICARE:   SHANTAE  CARTER
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
1374U00000XHome Health Aide

General Provider Information

NPI Number : 1992495741
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHANTAE CARTER
Provider Business Mailing Address
First Line : 23738 W WARREN ST APT 5
Second Line :
City : DEARBORN HEIGHTS
State : MI
Zip : 48127-4402
Country : US
Telephone Number : 313-859-1175
Fax Number :
Provider Business Practice Location Address
First Line : 23738 W WARREN ST APT 5
Second Line :
City : DEARBORN HEIGHTS
State : MI
Zip : 48127-4402
Country : US
Telephone Number : 313-859-1175
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/15/2023
Last Update Date : 05/15/2023

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Directions to “ SHANTAE CARTER ” Practice Location

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