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General NPI Number Information
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NPI Number | 1659215861
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Entity Type | Individual
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Provider Name | LONNELL CARTER CERTIFIED PEDORTHIST
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Gender | Male
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Dates
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Enumeration Date | 04/17/2026
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Last Update Date | 04/17/2026
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Provider Practice Location Address
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Address Line | 8310 MEDICAL PLAZA DR
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City | CHARLOTTE
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State | NC
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Zip | 28262-6701
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Country | US
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Telephone | 704-510-1300
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Fax |
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Provider Business Mailing Address
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Address Line | 564 GREY HAWK LN
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City | BLYTHEWOOD
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State | SC
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Zip | 29016-7133
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Country | US
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Telephone | 404-641-0882
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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 | 224L00000X
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Taxonomy Name | Pedorthist
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License Number | CPED1550
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License Number State | SC
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