Provider Demographics
NPI:1376519108
Name:CARTER, ROBERT ANDERSON (DC)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:ANDERSON
Last Name:CARTER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 MILLS AVE
Mailing Address - Street 2:SUITE E
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29605-4280
Mailing Address - Country:US
Mailing Address - Phone:864-233-3364
Mailing Address - Fax:864-233-3464
Practice Address - Street 1:500 MILLS AVE
Practice Address - Street 2:SUITE E
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29605-4280
Practice Address - Country:US
Practice Address - Phone:864-233-3364
Practice Address - Fax:864-233-3464
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-23
Last Update Date:2008-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2000111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCU63413Medicare ID - Type Unspecified