Healthcare Provider Details

I. General information

NPI: 1306828066
Provider Name (Legal Business Name): DEBRA A CARTER-MILLER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DEBRA A CARTER

II. Dates (important events)

Enumeration Date: 11/17/2005
Last Update Date: 10/15/2024
Certification Date: 10/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 E 34TH ST
INDIANAPOLIS IN
46205-3408
US

IV. Provider business mailing address

9723 E US HIGHWAY 36
AVON IN
46123-7979
US

V. Phone/Fax

Practice location:
  • Phone: 317-924-4545
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number01028113A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: