Provider Demographics
NPI:1649381526
Name:CARTER, AL JOSEPH
Entity Type:Individual
Prefix:MR
First Name:AL
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 1:210 N BETHESDA RD
Mailing Address - Street 2:
Mailing Address - City:SOUTHERN PINES
Mailing Address - State:NC
Mailing Address - Zip Code:28387-6709
Mailing Address - Country:US
Mailing Address - Phone:910-692-4668
Mailing Address - Fax:910-692-0610
Practice Address - Street 1:115 CARDINAL RD
Practice Address - Street 2:
Practice Address - City:SOUTHERN PINES
Practice Address - State:NC
Practice Address - Zip Code:28387-2903
Practice Address - Country:US
Practice Address - Phone:910-692-4032
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC091331163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8050424Medicaid
NC260009EMedicare PIN