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NPI Code Detail

MEDICARE: CHARLES L. CARTER M.D.

MEDICARE:   CHARLES L. CARTER  M.D.
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
1207R00000XInternal Medicine Physician018774TN

General Provider Information

NPI Number : 1558362707
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHARLES L. CARTER M.D.
Provider Business Mailing Address
First Line : PO BOX 40027
Second Line :
City : MEMPHIS
State : TN
Zip : 38174-0027
Country : US
Telephone Number : 901-761-6157
Fax Number : 901-761-4145
Provider Business Practice Location Address
First Line : 6263 POPLAR AVE
Second Line : SUITE 1052
City : MEMPHIS
State : TN
Zip : 38119-4701
Country : US
Telephone Number : 901-761-6157
Fax Number : 901-761-4145
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/09/2005
Last Update Date : 07/08/2007

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Directions to “ CHARLES L. CARTER M.D.” Practice Location

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