Provider Demographics
NPI:1013044619
Name:CARTER, WILLIAM D (DC)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:D
Last Name:CARTER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1303 1ST ST NE STE 100
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:MN
Mailing Address - Zip Code:55313-2167
Mailing Address - Country:US
Mailing Address - Phone:763-682-4000
Mailing Address - Fax:
Practice Address - Street 1:1303 1ST ST NE STE 100
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:MN
Practice Address - Zip Code:55313-2167
Practice Address - Country:US
Practice Address - Phone:763-682-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2023-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11244111N00000X
MN4437111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN692924OtherACN GROUP
MN372R9CAOtherBLUE CROSS BLUE SHIELD
MN163075000Medicaid
MN4496342OtherMEDICA
MNCC1098AOtherCHIRO CARE OF MN
MN692924OtherACN GROUP