Provider Demographics
NPI:1639152515
Name:CARTER, TED ALAN (MD)
Entity Type:Individual
Prefix:
First Name:TED
Middle Name:ALAN
Last Name:CARTER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:3495 PIEDMONT RD NE
Mailing Address - Street 2:NINE PIEDMONT CENTER
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30305-1736
Mailing Address - Country:US
Mailing Address - Phone:404-364-7000
Mailing Address - Fax:
Practice Address - Street 1:2525 CUMBERLAND PARKWAY
Practice Address - Street 2:KP CUMBERLAND MEDICAL CENTER
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30339
Practice Address - Country:US
Practice Address - Phone:770-434-2008
Practice Address - Fax:770-431-4388
Is Sole Proprietor?:No
Enumeration Date:2005-11-23
Last Update Date:2008-05-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA49486207Q00000X
AL24100207Q00000X
CO43902207Q00000X
GA049486207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAH93622Medicare UPIN