Provider Demographics
NPI:1235316407
Name:CARTER, JESSICA FRIEDLAND (MD)
Entity Type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:FRIEDLAND
Last Name:CARTER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:JESSICA
Other - Middle Name:PAIGE
Other - Last Name:FRIEDLAND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:6602 WATERS AVE
Mailing Address - Street 2:BUILDING C
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31406-2778
Mailing Address - Country:US
Mailing Address - Phone:912-354-7676
Mailing Address - Fax:912-354-6040
Practice Address - Street 1:6602 WATERS AVE
Practice Address - Street 2:BUILDING C
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31406-2778
Practice Address - Country:US
Practice Address - Phone:912-354-7676
Practice Address - Fax:912-354-6040
Is Sole Proprietor?:No
Enumeration Date:2008-01-30
Last Update Date:2012-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0594102084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA667371453BMedicaid
GA667371453CMedicaid