Provider Demographics
NPI:1467415687
Name:CARTER, ANDREW W (MD)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:W
Last Name:CARTER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:10105 E VIA LINDA
Mailing Address - Street 2:STE 103-282
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258-5311
Mailing Address - Country:US
Mailing Address - Phone:480-767-0010
Mailing Address - Fax:480-767-0030
Practice Address - Street 1:9522 E SAN SALVADOR DR
Practice Address - Street 2:STE 319
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-5557
Practice Address - Country:US
Practice Address - Phone:480-767-0010
Practice Address - Fax:480-767-0030
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-10
Last Update Date:2011-05-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ31605207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ783705Medicaid
AZ1Z0270OtherHEALTHNET
AZH66237Medicare UPIN
AZ783705Medicaid