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NPI Code Detail

MEDICARE: ANGELINE A CARTER PAC

MEDICARE: ANGELINE A CARTER PAC
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
1363AM0700XMedical Physician Assistant5601003199MI

General Provider Information

NPI Number : 1851493241
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANGELINE A CARTER PAC
Provider Business Mailing Address
First Line : 2674 BEMBRIDGE RD
Second Line :
City : ROYAL OAK
State : MI
Zip : 48073-2921
Country : US
Telephone Number : 248-549-4725
Fax Number :
Provider Business Practice Location Address
First Line : 2674 BEMBRIDGE RD
Second Line :
City : ROYAL OAK
State : MI
Zip : 48073-2921
Country : US
Telephone Number : 248-549-4725
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/05/2006
Last Update Date : 01/18/2008

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Directions to “ ANGELINE A CARTER PAC” Practice Location

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