Healthcare Provider Details

I. General information

NPI: 1922534999
Provider Name (Legal Business Name): CHARISSE DONNELL CARTER DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2017
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8160 SEATON PL
MONTGOMERY AL
36116-7204
US

IV. Provider business mailing address

1529 INTERNATIONAL BLVD STE 103
NORFOLK VA
23513-4802
US

V. Phone/Fax

Practice location:
  • Phone: 334-272-1799
  • Fax:
Mailing address:
  • Phone: 757-855-6800
  • Fax: 757-855-7771

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number4660
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: