Provider Demographics
NPI:1356301956
Name:CARTER, DENISE W (OD)
Entity Type:Individual
Prefix:DR
First Name:DENISE
Middle Name:W
Last Name:CARTER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:SUNGATE MEDICAL GROUP LLC
Mailing Address - Street 2:10 WILLIAM POPE DRIVE
Mailing Address - City:BLUFFTON
Mailing Address - State:SC
Mailing Address - Zip Code:29909-7549
Mailing Address - Country:US
Mailing Address - Phone:843-842-2020
Mailing Address - Fax:843-705-1512
Practice Address - Street 1:33 KEMMERLIN LN
Practice Address - Street 2:
Practice Address - City:LADYS ISLAND
Practice Address - State:SC
Practice Address - Zip Code:29907-2702
Practice Address - Country:US
Practice Address - Phone:843-521-2020
Practice Address - Fax:843-524-7559
Is Sole Proprietor?:No
Enumeration Date:2006-03-27
Last Update Date:2020-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCSC 1022152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCD10227Medicaid
SCD10227Medicaid