Provider Demographics
NPI:1336280114
Name:CARTER, NICOLE DUPRAW (MD)
Entity Type:Individual
Prefix:DR
First Name:NICOLE
Middle Name:DUPRAW
Last Name:CARTER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:NICOLE
Other - Middle Name:MARIE
Other - Last Name:DUPRAW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2401 VILLAGE PROFESSIONAL PKWY
Mailing Address - Street 2:
Mailing Address - City:OPELIKA
Mailing Address - State:AL
Mailing Address - Zip Code:36801-4702
Mailing Address - Country:US
Mailing Address - Phone:334-749-8121
Mailing Address - Fax:334-749-6166
Practice Address - Street 1:2401 VILLAGE PROFESSIONAL PKWY
Practice Address - Street 2:
Practice Address - City:OPELIKA
Practice Address - State:AL
Practice Address - Zip Code:36801-4702
Practice Address - Country:US
Practice Address - Phone:334-749-8121
Practice Address - Fax:334-749-6166
Is Sole Proprietor?:No
Enumeration Date:2007-02-12
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL25967208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL515-22781OtherBCBS AL PROV # OPELIKA
37544OtherAMERICAN BOARD PEDIATRICS
AL25967OtherALABAMA MEDICAL LICENSE
AL25967OtherALABAMA CONTR SUBST CERT
AL515-22782OtherBCBS AL PROV # AUBURN
926662OtherAAP ID
926662OtherAAP ID
AL515-22781OtherBCBS AL PROV # OPELIKA
AL25967OtherALABAMA CONTR SUBST CERT