Provider Demographics
NPI:1952380545
Name:LINDSAY, CARLOTTA MARVETTE (MD)
Entity Type:Individual
Prefix:MS
First Name:CARLOTTA
Middle Name:MARVETTE
Last Name:LINDSAY
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 1:9377 N US HIGHWAY 301
Mailing Address - Street 2:
Mailing Address - City:WHITAKERS
Mailing Address - State:NC
Mailing Address - Zip Code:27891-8621
Mailing Address - Country:US
Mailing Address - Phone:252-437-9211
Mailing Address - Fax:252-437-9774
Practice Address - Street 1:9377 N US HIGHWAY 301
Practice Address - Street 2:
Practice Address - City:WHITAKERS
Practice Address - State:NC
Practice Address - Zip Code:27891-8621
Practice Address - Country:US
Practice Address - Phone:252-437-9211
Practice Address - Fax:252-437-9774
Is Sole Proprietor?:No
Enumeration Date:2006-01-11
Last Update Date:2022-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD068327L207Q00000X
PAMD068327-L207Q00000X
NC2014-01372207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001774348Medicaid
NCNCJ472AMedicare UPIN
PA001774348Medicaid
NCNCJ472AMedicare UPIN