MEDICARE: PUJEETA CARTER CRNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	R182333	MD

General Provider Information

NPI Number	:	1134559404
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PUJEETA CARTER CRNP

Provider Business Mailing Address
First Line	:	1437 LOWMAN ST
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21230-5228
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1437 LOWMAN ST
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21230-5228
Country	:	US
Telephone Number	:	410-837-6077
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/22/2013
Last Update Date	:	11/22/2013

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