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General NPI Number Information
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NPI Number | 1194338913
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Entity Type | Individual
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Provider Name | MICHAEL CARTER
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Gender | Male
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Dates
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Enumeration Date | 08/31/2020
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Last Update Date | 09/02/2020
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Provider Practice Location Address
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Address Line | 301 MARYLAND AVE
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City | PORTSMOUTH
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State | VA
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Zip | 23707-1714
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Country | US
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Telephone | 757-537-8736
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Fax | 757-913-1376
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Provider Business Mailing Address
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Address Line | PO BOX 2142
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City | PORTSMOUTH
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State | VA
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Zip | 23702-0142
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Country | US
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Telephone | 757-537-8736
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Fax | 757-913-1376
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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 | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number | T62621880
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License Number State | VA
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