Provider Demographics
NPI:1992753107
Name:CARTER, SALLIE A (MD)
Entity type:Individual
Prefix:DR
First Name:SALLIE
Middle Name:A
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 1:200 MCGEE RD
Mailing Address - Street 2:
Mailing Address - City:ANDERSON
Mailing Address - State:SC
Mailing Address - Zip Code:29625-2142
Mailing Address - Country:US
Mailing Address - Phone:864-260-2220
Mailing Address - Fax:864-260-2225
Practice Address - Street 1:200 MCGEE RD
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:SC
Practice Address - Zip Code:29625-2142
Practice Address - Country:US
Practice Address - Phone:864-260-2220
Practice Address - Fax:864-260-2225
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2018-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC14622208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCE12479Medicare UPIN