Provider Demographics
NPI:1609966456
Name:CARTER, CYNTHIA LEE (MD)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:LEE
Last Name:CARTER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CINDY
Other - Middle Name:LEE
Other - Last Name:CARTER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:500 E OGLETHORPE HWY
Mailing Address - Street 2:
Mailing Address - City:HINESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31313-2804
Mailing Address - Country:US
Mailing Address - Phone:912-408-2944
Mailing Address - Fax:912-876-1190
Practice Address - Street 1:500 E OGLETHORPE HWY
Practice Address - Street 2:
Practice Address - City:HINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:31313-2804
Practice Address - Country:US
Practice Address - Phone:912-408-2944
Practice Address - Fax:912-876-1190
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2021-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA056534207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003130605AMedicaid
GAP01139821OtherRAILROAD MEDICARE
SCG56534Medicaid
SCG56534Medicaid
GA003130605AMedicaid