Provider Demographics
NPI:1386649754
Name:CARTER, JEAN WHITMORE (MD)
Entity Type:Individual
Prefix:
First Name:JEAN
Middle Name:WHITMORE
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 1:4414 LAKE BOONE TRL
Mailing Address - Street 2:STE 210
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27607-7505
Mailing Address - Country:US
Mailing Address - Phone:919-571-1040
Mailing Address - Fax:919-781-0247
Practice Address - Street 1:4414 LAKE BOONE TRL
Practice Address - Street 2:STE 210
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27607-7505
Practice Address - Country:US
Practice Address - Phone:919-571-1040
Practice Address - Fax:919-781-0247
Is Sole Proprietor?:No
Enumeration Date:2005-06-14
Last Update Date:2014-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC30139207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8921524Medicaid
21524OtherBCBS
NC205313Medicare PIN
C25706Medicare UPIN