Provider Demographics
NPI:1740747187
Name:CARTER, JOYCE E (PARA-MEDICAL)
Entity Type:Individual
Prefix:
First Name:JOYCE
Middle Name:E
Last Name:CARTER
Suffix:
Gender:F
Credentials:PARA-MEDICAL
Other - Prefix:
Other - First Name:JOYCE
Other - Middle Name:E
Other - Last Name:CARTER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PARA MEDICAL
Mailing Address - Street 1:126 CONGAREE DR
Mailing Address - Street 2:
Mailing Address - City:RAEFORD
Mailing Address - State:NC
Mailing Address - Zip Code:28376-5313
Mailing Address - Country:US
Mailing Address - Phone:910-286-4635
Mailing Address - Fax:
Practice Address - Street 1:1404 HOPE MILLS RD
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28304-4219
Practice Address - Country:US
Practice Address - Phone:910-286-4635
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-21
Last Update Date:2019-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC70975207NS0135X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural DermatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCC70975OtherHAIR LOSS RESTORATION SERVICES