Provider Demographics
NPI:1912089251
Name:CARTER, ROSSANA Y (MD)
Entity Type:Individual
Prefix:
First Name:ROSSANA
Middle Name:Y
Last Name:CARTER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:330 HOSPITAL DR
Mailing Address - Street 2:SUITE 304
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31217-3899
Mailing Address - Country:US
Mailing Address - Phone:478-742-1010
Mailing Address - Fax:478-742-4561
Practice Address - Street 1:330 HOSPITAL DR
Practice Address - Street 2:SUITE 304
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31217-3899
Practice Address - Country:US
Practice Address - Phone:478-742-1010
Practice Address - Fax:478-742-4561
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-19
Last Update Date:2016-06-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA040633207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA202I114912Medicare Oscar/Certification
GA000915109AMedicaid
G75549Medicare UPIN
GA110225065OtherRAILROAD MEDICARE
GA11BDTSBMedicare PIN