MEDICARE: DR. DENISE W CARTER OD

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	152W00000X	Optometrist	SC 1022	SC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1356301956
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DENISE W CARTER OD

Provider Business Mailing Address
First Line	:	SUNGATE MEDICAL GROUP LLC
Second Line	:	10 WILLIAM POPE DRIVE
City	:	BLUFFTON
State	:	SC
Zip	:	29909-7549
Country	:	US
Telephone Number	:	843-842-2020
Fax Number	:	843-705-1512

Provider Business Practice Location Address
First Line	:	33 KEMMERLIN LN
Second Line	:
City	:	LADYS ISLAND
State	:	SC
Zip	:	29907-2702
Country	:	US
Telephone Number	:	843-521-2020
Fax Number	:	843-524-7559

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

Provider Enumeration Date	:	03/27/2006
Last Update Date	:	02/04/2020

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