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General NPI Number Information
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NPI Number | 1184965303
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Entity Type | Individual
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Provider Name | THOMAS CARTER CPS-M
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Gender | Male
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Dates
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Enumeration Date | 03/13/2013
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Last Update Date | 03/13/2013
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Provider Practice Location Address
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Address Line | 301 E GENESEE AVE SUITE 201
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City | SAGINAW
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State | MI
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Zip | 48607-1242
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Country | US
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Telephone | 989-776-6000
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Fax |
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Provider Business Mailing Address
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Address Line | 922 N 4TH AVE
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City | SAGINAW
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State | MI
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Zip | 48601-1015
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Country | US
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Telephone |
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Fax |
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 101YA0400X
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License Number State |
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