Provider Demographics
NPI:1477593655
Name:CARTER, DEBORAH S (MD)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:S
Last Name:CARTER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:DEBORAH
Other - Middle Name:A
Other - Last Name:STENGEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 602484
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-2484
Mailing Address - Country:US
Mailing Address - Phone:910-343-9991
Mailing Address - Fax:910-343-8448
Practice Address - Street 1:1960 S 16TH ST
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28401-6676
Practice Address - Country:US
Practice Address - Phone:910-343-9991
Practice Address - Fax:910-343-8448
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2016-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200300094207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC891362MMedicaid
NC1477593655Medicaid
NC2025632AMedicare PIN
NCP00153165Medicare PIN
NC891362MMedicaid
NC1022110001Medicare NSC
I06260Medicare UPIN