Provider Demographics
NPI:1992080220
Name:CARTER, CHRISTOPH C (MD PHD)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPH
Middle Name:C
Last Name:CARTER
Suffix:
Gender:M
Credentials:MD PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7248 CAMINO DEGRAZIA
Mailing Address - Street 2:UNIT 292
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92111-7851
Mailing Address - Country:US
Mailing Address - Phone:734-657-1401
Mailing Address - Fax:
Practice Address - Street 1:7248 CAMINO DEGRAZIA
Practice Address - Street 2:UNIT 292
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92111-7851
Practice Address - Country:US
Practice Address - Phone:734-657-1401
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-18
Last Update Date:2011-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program