Provider Demographics
NPI:1558708388
Name:CARTER, MARSHAL DWAIN (PHARMD, BCGP)
Entity Type:Individual
Prefix:DR
First Name:MARSHAL
Middle Name:DWAIN
Last Name:CARTER
Suffix:
Gender:M
Credentials:PHARMD, BCGP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8120 UNIVERSITY CITY BLVD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28213-8126
Mailing Address - Country:US
Mailing Address - Phone:704-454-2526
Mailing Address - Fax:
Practice Address - Street 1:8120 UNIVERSITY CITY BLVD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28213-8126
Practice Address - Country:US
Practice Address - Phone:704-454-2526
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-03
Last Update Date:2020-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI03706400183500000X
NC23208183500000X
NY060360183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist