Provider Demographics
NPI:1780688689
Name:CARTER, PATRICIA G (MD)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:G
Last Name:CARTER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7370 N LA CHOLLA BLVD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85741-2305
Mailing Address - Country:US
Mailing Address - Phone:520-742-6863
Mailing Address - Fax:520-742-6443
Practice Address - Street 1:7370 N LA CHOLLA BLVD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85741-2305
Practice Address - Country:US
Practice Address - Phone:520-742-6863
Practice Address - Fax:520-742-6443
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-08
Last Update Date:2008-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ17241207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ26734OtherCIGNA
AZ26737OtherMEDICARE PIN
AZ1Z7726OtherHEALTH NET
AZ0400380OtherUNITED MEDICARE
AZ1049361OtherFIRST HEALTH
AZ2125434OtherAEATN HEALTHCARE
AZ2272117OtherAETNA GROUP
AZ30019663OtherTAT NUMBER
ASAZ08040480OtherBLUE CROSS BLUE SHIELD
AZ1Z7726OtherHEALTH NET
AZ2125434OtherAEATN HEALTHCARE
AZ26734Medicare PIN