Healthcare Provider Details

I. General information

NPI: 1952380545
Provider Name (Legal Business Name): CARLOTTA MARVETTE LINDSAY M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/11/2006
Last Update Date: 08/15/2022
Certification Date: 07/24/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9377 N US HIGHWAY 301
WHITAKERS NC
27891-8621
US

IV. Provider business mailing address

9377 N US HIGHWAY 301
WHITAKERS NC
27891-8621
US

V. Phone/Fax

Practice location:
  • Phone: 252-437-9211
  • Fax: 252-437-9774
Mailing address:
  • Phone: 252-437-9211
  • Fax: 252-437-9774

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD068327L
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD068327-L
License Number StatePA
# 3
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number2014-01372
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: