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1659582286

NPI Code Detail

MEDICARE: SHAWN STAFFORD CARTER MD

MEDICARE: SHAWN STAFFORD 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	2085R0202X	Diagnostic Radiology Physician	ME119355	FL
2	207U00000X	Nuclear Medicine Physician	ME119355	FL
3	207U00000X	Nuclear Medicine Physician	2009-0003	NC

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	OU964	OTHER	FL	HF MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	ITM0X	OTHER	FL	FLORIDA BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1659582286
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHAWN STAFFORD CARTER MD

Provider Business Mailing Address
First Line	:	PO BOX 102222
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30368-2222
Country	:	US
Telephone Number	:	239-274-8200
Fax Number	:

Provider Business Practice Location Address
First Line	:	3402 W DR MARTIN LUTHER KING JR BLVD
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33607-6214
Country	:	US
Telephone Number	:	813-875-3950
Fax Number	:	813-872-2741

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

Provider Enumeration Date	:	05/25/2007
Last Update Date	:	02/09/2026

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Directions to “ SHAWN STAFFORD CARTER MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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