Provider Demographics
NPI:1346221405
Name:CARTER, MARTHA W (MD)
Entity Type:Individual
Prefix:
First Name:MARTHA
Middle Name:W
Last Name:CARTER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 24776
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37422-4776
Mailing Address - Country:US
Mailing Address - Phone:877-288-1799
Mailing Address - Fax:423-892-5838
Practice Address - Street 1:82 PATTON AVE
Practice Address - Street 2:SUITE 510
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-3319
Practice Address - Country:US
Practice Address - Phone:828-398-5215
Practice Address - Fax:828-210-9388
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-07
Last Update Date:2014-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN24085207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3147402OtherBLUE CROSS BLUE SHIELD TN
TN3854785Medicaid
TN3854785Medicare PIN
TNG80450Medicare UPIN
TN3854785Medicaid