Provider Demographics
NPI:1457379711
Name:CARTER, MAYA JAMILAH (MD)
Entity Type:Individual
Prefix:DR
First Name:MAYA
Middle Name:JAMILAH
Last Name:CARTER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:3355 CASCADE RD SW
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30311-3678
Mailing Address - Country:US
Mailing Address - Phone:404-691-2529
Mailing Address - Fax:404-691-2382
Practice Address - Street 1:3355 CASCADE RD SW
Practice Address - Street 2:SUITE 100
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30311-3678
Practice Address - Country:US
Practice Address - Phone:404-691-2529
Practice Address - Fax:404-691-2382
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2013-05-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036116034207Q00000X
GA059904207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
I59043Medicare UPIN