Provider Demographics
NPI:1417057787
Name:CARTER, MONICA SHAMSID-DEEN (DO)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:SHAMSID-DEEN
Last Name:CARTER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 SUMMIT AVE
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27405-4522
Mailing Address - Country:US
Mailing Address - Phone:336-621-2500
Mailing Address - Fax:336-690-5423
Practice Address - Street 1:2500 SUMMIT AVE
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27405
Practice Address - Country:US
Practice Address - Phone:336-621-2500
Practice Address - Fax:336-690-5423
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200601566207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCP00370070OtherRAILROAD MEDICARE
NCP00456671OtherRAILROAD MEDICARE
NC5905228Medicaid
NC5905228Medicaid
BC9715585OtherFEDERAL DEA
NCP00456671OtherRAILROAD MEDICARE