Provider Demographics
NPI:1487750733
Name:CARTER, H. ANTHONY (MD)
Entity type:Individual
Prefix:
First Name:H.
Middle Name:ANTHONY
Last Name:CARTER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:194 HOWARD ST
Mailing Address - Street 2:
Mailing Address - City:NEW LONDON
Mailing Address - State:CT
Mailing Address - Zip Code:06320-5544
Mailing Address - Country:US
Mailing Address - Phone:860-444-3366
Mailing Address - Fax:860-444-3377
Practice Address - Street 1:194 HOWARD ST
Practice Address - Street 2:
Practice Address - City:NEW LONDON
Practice Address - State:CT
Practice Address - Zip Code:06320-5544
Practice Address - Country:US
Practice Address - Phone:860-444-3366
Practice Address - Fax:860-444-3377
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2024-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT52597207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT1487750733Medicaid
GAG90415OtherUPIN
CTD400122344Medicare PIN