Healthcare Provider Details

I. General information

NPI: 1629668926
Provider Name (Legal Business Name): JOHN ALEXANDER CARTER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/20/2021
Last Update Date: 06/07/2024
Certification Date: 06/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1656 RIVERCHASE BLVD STE 3400
ROCK HILL SC
29732-0273
US

IV. Provider business mailing address

1656 RIVERCHASE BLVD STE 3400
ROCK HILL SC
29732-0273
US

V. Phone/Fax

Practice location:
  • Phone: 803-328-6281
  • Fax:
Mailing address:
  • Phone: 803-328-6281
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number321088
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD91664
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: