MEDICARE: CURTIS CARTER

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	171W00000X	Contractor

General Provider Information

NPI Number	:	1972214344
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CURTIS CARTER

Provider Business Mailing Address
First Line	:	2588 RAINOVER TRL
Second Line	:
City	:	DECATUR
State	:	GA
Zip	:	30034-2278
Country	:	US
Telephone Number	:	404-207-6970
Fax Number	:

Provider Business Practice Location Address
First Line	:	2588 RAINOVER TRL
Second Line	:
City	:	DECATUR
State	:	GA
Zip	:	30034-2278
Country	:	US
Telephone Number	:	404-207-6970
Fax Number	:

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

Provider Enumeration Date	:	12/07/2022
Last Update Date	:	12/07/2022

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Directions to “ CURTIS CARTER ” Practice Location

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