Provider Demographics
NPI:1528582467
Name:SMITH, CARTER D (MD, DPT)
Entity type:Individual
Prefix:
First Name:CARTER
Middle Name:D
Last Name:SMITH
Suffix:
Gender:M
Credentials:MD, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1215 LEE ST BOX 800713
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22908-0816
Mailing Address - Country:US
Mailing Address - Phone:434-924-5700
Mailing Address - Fax:434-924-1736
Practice Address - Street 1:1215 LEE ST BOX 800713
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22908-0816
Practice Address - Country:US
Practice Address - Phone:434-924-5700
Practice Address - Fax:434-924-1736
Is Sole Proprietor?:No
Enumeration Date:2017-08-02
Last Update Date:2025-04-30
Deactivation Date:2025-03-25
Deactivation Code:
Reactivation Date:2025-04-30
Provider Licenses
StateLicense IDTaxonomies
NCP17335225100000X
NC17335225100000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist