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General NPI Number Information
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NPI Number | 1164431755
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Entity Type | Individual
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Provider Name | ELISA M CARTER PA
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Gender | Female
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Dates
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Enumeration Date | 08/05/2006
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Last Update Date | 11/19/2020
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Provider Practice Location Address
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Address Line | 100 PLANK BRIDGE RD
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City | CAMDEN
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State | NC
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Zip | 27921
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Country | US
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Telephone | 252-331-1829
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Fax | 252-331-2916
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Provider Business Mailing Address
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Address Line | PO BOX 11314
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City | BELFAST
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State | ME
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Zip | 04915-4004
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Country | US
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Telephone | 757-842-4481
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Fax | 757-312-3135
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 0110001676
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 0110001676
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License Number State | VA
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