Provider Demographics
NPI:1184965303
Name:CARTER, THOMAS (CPS-M)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:
Last Name:CARTER
Suffix:
Gender:M
Credentials:CPS-M
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:922 N 4TH AVE
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48601-1015
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:301 E GENESEE AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48607-1242
Practice Address - Country:US
Practice Address - Phone:989-776-6000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-13
Last Update Date:2013-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist