MEDICARE: MATTHEW ALAN CARTER MD

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	208000000X	Pediatrics Physician	2006-0234	NM
2	208000000X	Pediatrics Physician	7282401-1205	UT

General Provider Information

NPI Number	:	1548309552
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MATTHEW ALAN CARTER MD

Provider Business Mailing Address
First Line	:	6272 S HIGHLAND DR
Second Line	:
City	:	MURRAY
State	:	UT
Zip	:	84121-2126
Country	:	US
Telephone Number	:	801-871-6200
Fax Number	:	801-871-6250

Provider Business Practice Location Address
First Line	:	6272 S HIGHLAND DR
Second Line	:
City	:	MURRAY
State	:	UT
Zip	:	84121-2126
Country	:	US
Telephone Number	:	801-871-6200
Fax Number	:	801-871-6250

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

Provider Enumeration Date	:	02/06/2007
Last Update Date	:	10/11/2012

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