Healthcare Provider Details

I. General information

NPI: 1386681302
Provider Name (Legal Business Name): MICHELLE R CARTER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MICHELLE R CHESLEY M.D.

II. Dates (important events)

Enumeration Date: 05/31/2006
Last Update Date: 09/17/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2041 GEORGIA AVE NW
WASHINGTON DC
20060-0001
US

IV. Provider business mailing address

14805 TONGUE AVE
BOWIE MD
20715-2560
US

V. Phone/Fax

Practice location:
  • Phone: 202-865-1121
  • Fax: 202-865-4492
Mailing address:
  • Phone: 301-367-7168
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberMD035313
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: