Provider Demographics
NPI:1124202379
Name:CARTER, ESTELLE W (PA-C)
Entity Type:Individual
Prefix:
First Name:ESTELLE
Middle Name:W
Last Name:CARTER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 MILLPOND CT
Mailing Address - Street 2:
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-1375
Mailing Address - Country:US
Mailing Address - Phone:443-629-0583
Mailing Address - Fax:
Practice Address - Street 1:29 S PACA ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201-1771
Practice Address - Country:US
Practice Address - Phone:667-214-1800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-24
Last Update Date:2021-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDC01427363A00000X
MDC0001427207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant