Provider Demographics
NPI:1962529990
Name:CARTER, BETH A (MD)
Entity type:Individual
Prefix:
First Name:BETH
Middle Name:A
Last Name:CARTER
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:PO BOX 77000 DEPT 77220
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48277-2000
Mailing Address - Country:US
Mailing Address - Phone:734-462-0340
Mailing Address - Fax:734-462-0344
Practice Address - Street 1:18900 W 10 MILE RD
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075-2669
Practice Address - Country:US
Practice Address - Phone:248-424-8340
Practice Address - Fax:248-424-7209
Is Sole Proprietor?:No
Enumeration Date:2007-03-23
Last Update Date:2015-01-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI43010655302083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIP46120005Medicare UPIN
MIMI1503004Medicare UPIN
MIOP46120Medicare PIN
MIMI1504004Medicare UPIN