Provider Demographics
NPI:1902863566
Name:CARTER, NATHANIEL (MD)
Entity Type:Individual
Prefix:DR
First Name:NATHANIEL
Middle Name:
Last Name:CARTER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5980
Mailing Address - Street 2:
Mailing Address - City:PIKESVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21282-5980
Mailing Address - Country:US
Mailing Address - Phone:410-740-1000
Mailing Address - Fax:410-740-1003
Practice Address - Street 1:10724 LITTLE PATUXENT PKWY STE 101
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21044-3253
Practice Address - Country:US
Practice Address - Phone:410-740-1000
Practice Address - Fax:410-740-1003
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-27
Last Update Date:2020-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD466332084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD105602100Medicaid
MD1740455039Medicaid