Healthcare Provider Details

I. General information

NPI: 1902729726
Provider Name (Legal Business Name): TAMMIE ELIZABETH CARTER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/30/2026
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

603 W PATRICK ST STE B
FREDERICK MD
21701-4090
US

IV. Provider business mailing address

2 JAMES ST APT 2A
FREDERICK MD
21701-6256
US

V. Phone/Fax

Practice location:
  • Phone: 301-620-1414
  • Fax:
Mailing address:
  • Phone: 240-397-1893
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberM04691
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: