MEDICARE: STEVIE CARTER PA-C

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	363A00000X	Physician Assistant	PA031456	DC
2	363A00000X	Physician Assistant		TX
3	363A00000X	Physician Assistant	C06818	MD

General Provider Information

NPI Number	:	1285009993
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEVIE CARTER PA-C

Provider Business Mailing Address
First Line	:	6201 GREENLEIGH AVE
Second Line	:
City	:	MIDDLE RIVER
State	:	MD
Zip	:	21220-2004
Country	:	US
Telephone Number	:	410-933-0000
Fax Number	:

Provider Business Practice Location Address
First Line	:	6602 MEMORIAL DR
Second Line	:
City	:	TEXAS CITY
State	:	TX
Zip	:	77591-4013
Country	:	US
Telephone Number	:	409-935-2451
Fax Number	:

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

Provider Enumeration Date	:	12/07/2015
Last Update Date	:	08/08/2025

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Directions to “ STEVIE CARTER PA-C” Practice Location

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