Healthcare Provider Details

I. General information

NPI: 1538097001
Provider Name (Legal Business Name): LEWIS CARTER JR.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

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

III. Provider practice location address

2831 WHITEWOOD ST
ANN ARBOR MI
48104-5367
US

IV. Provider business mailing address

2831 WHITEWOOD ST
ANN ARBOR MI
48104-5367
US

V. Phone/Fax

Practice location:
  • Phone: 734-352-0284
  • Fax:
Mailing address:
  • Phone: 734-352-0284
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246Z00000X
TaxonomyOther Specialist/Technologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: