Provider Demographics
NPI:1518051531
Name:CARTER, JAMES JACQUES (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:JACQUES
Last Name:CARTER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:J.
Other - Middle Name:JACQUES
Other - Last Name:CARTER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:330 BROOKLINE AVE., SHAPIRO 1, ATRIUM SUITE
Mailing Address - Street 2:B.I. DEACONESS MED CTR
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02215
Mailing Address - Country:US
Mailing Address - Phone:617-667-9600
Mailing Address - Fax:617-667-6406
Practice Address - Street 1:330 BROOKLINE AVE.
Practice Address - Street 2:HMFP AT BETH ISRAEL DEACONESS MEDICAL
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02215
Practice Address - Country:US
Practice Address - Phone:617-667-9600
Practice Address - Fax:617-667-6406
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2011-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA46576207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAB74202Medicare UPIN