Provider Demographics
NPI:1104888973
Name:CARTER, STEPHANIE D (MD)
Entity type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:D
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 1:8109 HINSON FARM RD
Mailing Address - Street 2:SUITE 504
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22306-3415
Mailing Address - Country:US
Mailing Address - Phone:703-780-2800
Mailing Address - Fax:
Practice Address - Street 1:8109 HINSON FARM RD
Practice Address - Street 2:SUITE 504
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22306-3415
Practice Address - Country:US
Practice Address - Phone:703-780-2800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-05
Last Update Date:2012-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101058333207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA00X172M10Medicare UPIN
DC003822M75Medicare UPIN