Provider Demographics
NPI:1114931730
Name:CARTER, WILLIAM EDGAR JR (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:EDGAR
Last Name:CARTER
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:5454 YORKTOWNE DR
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30349-5317
Mailing Address - Country:US
Mailing Address - Phone:770-991-6044
Mailing Address - Fax:770-997-2757
Practice Address - Street 1:5454 YORKTOWNE DR
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30349-5317
Practice Address - Country:US
Practice Address - Phone:770-991-6044
Practice Address - Fax:770-997-2757
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0438962084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00815097BMedicaid
GAG64690Medicare UPIN
GA26BDHKMMedicare ID - Type Unspecified