Provider Demographics
NPI:1497747984
Name:CARTER, MICHELLE KAYE (OD)
Entity Type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:KAYE
Last Name:CARTER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 HILL AVE
Mailing Address - Street 2:
Mailing Address - City:GRAFTON
Mailing Address - State:ND
Mailing Address - Zip Code:58237-1001
Mailing Address - Country:US
Mailing Address - Phone:701-352-1370
Mailing Address - Fax:701-352-1376
Practice Address - Street 1:415 HILL AVE
Practice Address - Street 2:
Practice Address - City:GRAFTON
Practice Address - State:ND
Practice Address - Zip Code:58237-1001
Practice Address - Country:US
Practice Address - Phone:701-352-1370
Practice Address - Fax:701-352-1376
Is Sole Proprietor?:No
Enumeration Date:2005-08-19
Last Update Date:2011-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND573152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND1497747984OtherNPI
ND22784OtherBCBS, ND
MN51159CAOtherBCBS, MN
ND60526Medicaid
ND860573OtherND VISION SERVICES
ND22784Medicare PIN
ND22784OtherBCBS, ND