Provider Demographics
NPI:1609006204
Name:CARTER, BRIAN JOSEPH
Entity Type:Individual
Prefix:MR
First Name:BRIAN
Middle Name:JOSEPH
Last Name:CARTER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1050 JABARA AVENUE
Mailing Address - Street 2:4 AMDS/SGGF (ATTN: MSGT B. CARTER
Mailing Address - City:SEYMOUR JOHNSON
Mailing Address - State:NC
Mailing Address - Zip Code:27531-2310
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1050 JABARA AVENUE
Practice Address - Street 2:4 AMDS/SGGF (ATTN: MSGT B. CARTER
Practice Address - City:SEYMOUR JOHNSON
Practice Address - State:NC
Practice Address - Zip Code:27531-2310
Practice Address - Country:US
Practice Address - Phone:919-722-1580
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-17
Last Update Date:2009-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1003XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Medical Technicians