# INDIAN LAND PEDIATRICS, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1306118583
- **Authorized official:** LUCRETIA ANN CARTER MD (OWNER)
- **Authorized official phone:** (803) 396-1090

## Contact information

- **Practice address:** 7580 CHARLOTTE HWY, SUITE 1000, FORT MILL, SC 29707-7801
- **Practice address phone:** (803) 396-1090
- **Practice address fax:** (803) 396-1091
- **Mailing address:** 7580 CHARLOTTE HWY, SUITE 1000, FORT MILL, SC 29707-7801
- **Mailing address phone:** (803) 396-1090
- **Mailing address fax:** (803) 396-1091

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208000000X | Pediatrics Physician | — | NULL | Yes |
| 208000000X | Pediatrics Physician | — | — | Yes |

## Other

- **Enumeration date:** 02/02/2012
- **Last updated:** 11/27/2012