Healthcare Provider Details

I. General information

NPI: 1144489667
Provider Name (Legal Business Name): SCOTT CORY CARTER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2008
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

96 JONATHAN LUCAS ST # 323
CHARLESTON SC
29425-8900
US

IV. Provider business mailing address

96 JONATHAN LUCAS ST # 323
CHARLESTON SC
29425-3230
US

V. Phone/Fax

Practice location:
  • Phone: 843-792-4033
  • Fax: 843-792-1889
Mailing address:
  • Phone: 843-792-4033
  • Fax: 843-792-1889

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085P0229X
TaxonomyPediatric Radiology Physician
License Number96790
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberMD2008-0207
License Number StateNM
# 3
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number2015-01706
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: