Provider Demographics
NPI:1265592281
Name:CARTER, DOROTHY LINNEA (MD)
Entity type:Individual
Prefix:DR
First Name:DOROTHY
Middle Name:LINNEA
Last Name:CARTER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:431 TAHOSA PARK NORTH RD
Mailing Address - Street 2:
Mailing Address - City:ALLENSPARK
Mailing Address - State:CO
Mailing Address - Zip Code:80510-9717
Mailing Address - Country:US
Mailing Address - Phone:303-747-2926
Mailing Address - Fax:
Practice Address - Street 1:1333 IRIS AVE
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80304-2226
Practice Address - Country:US
Practice Address - Phone:303-443-8500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2014-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO216742084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01216746Medicaid
CO1629-1Medicare ID - Type Unspecified
COD49832Medicare UPIN