Provider Demographics
NPI:1063464501
Name:CARTER, AMY ELIZABETH (MD)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:ELIZABETH
Last Name:CARTER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5540 HIGHWAY 431 S
Mailing Address - Street 2:
Mailing Address - City:BROWNSBORO
Mailing Address - State:AL
Mailing Address - Zip Code:35741-9771
Mailing Address - Country:US
Mailing Address - Phone:256-533-3003
Mailing Address - Fax:256-533-3013
Practice Address - Street 1:5540 HIGHWAY 431 S
Practice Address - Street 2:
Practice Address - City:BROWNSBORO
Practice Address - State:AL
Practice Address - Zip Code:35741-9771
Practice Address - Country:US
Practice Address - Phone:256-533-3003
Practice Address - Fax:256-533-3013
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-16
Last Update Date:2012-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL25279207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALI12058Medicare UPIN