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General NPI Number Information
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NPI Number | 1750422069
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Entity Type | Individual
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Provider Name | SAMUEL DAVID CARTER M.D.
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Gender | Male
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Dates
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Enumeration Date | 02/09/2007
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Last Update Date | 10/13/2020
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Provider Practice Location Address
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Address Line | 9880 ANGIES WAY SUITE 250
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City | LOUISVILLE
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State | KY
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Zip | 40241-2851
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Country | US
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Telephone | 502-394-6341
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Fax | 502-394-6340
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Provider Business Mailing Address
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Address Line | PO BOX 776351
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City | CHICAGO
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State | IL
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Zip | 60677-6351
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Country | US
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Telephone | 502-588-9490
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Fax | 502-272-5116
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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 | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 42798
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License Number State | KY
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