Provider Demographics
NPI:1689963704
Name:CARTER, MICHAEL DONNELL
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:DONNELL
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 1:304 CARR MEADOW DR
Mailing Address - Street 2:
Mailing Address - City:RIDGELAND
Mailing Address - State:MS
Mailing Address - Zip Code:39157-1821
Mailing Address - Country:US
Mailing Address - Phone:601-383-2904
Mailing Address - Fax:
Practice Address - Street 1:304 CARR MEADOW DR
Practice Address - Street 2:
Practice Address - City:RIDGELAND
Practice Address - State:MS
Practice Address - Zip Code:39157-1821
Practice Address - Country:US
Practice Address - Phone:601-383-2904
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-29
Last Update Date:2011-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion
No372500000XNursing Service Related ProvidersChore Provider
No172V00000XOther Service ProvidersCommunity Health Worker
No171WH0202XOther Service ProvidersContractorHome Modifications
No172A00000XOther Service ProvidersDriver
No374K00000XNursing Service Related ProvidersReligious Nonmedical Practitioner