Healthcare Provider Details

I. General information

NPI: 1902022486
Provider Name (Legal Business Name): DANNY RAY CARTER R.PH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: DANA RAY CARTER R.PH

II. Dates (important events)

Enumeration Date: 04/17/2007
Last Update Date: 02/12/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4727 HAWKSBURY RD
PIKESVILLE MD
21208-2129
US

IV. Provider business mailing address

4727 HAWKSBURY RD
PIKESVILLE MD
21208-2129
US

V. Phone/Fax

Practice location:
  • Phone: 410-922-2573
  • Fax: 410-521-6798
Mailing address:
  • Phone: 410-922-2573
  • Fax: 410-521-6798

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835X0200X
TaxonomyOncology Pharmacist
License Number12766
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: