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Organization
RUSSELL P CARTER JR MD INC
Active
Organization
RUSSELL P CARTER JR MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RUSSELL PHILIP CARTER JR. MD (PRESIDENT/PHYSICIAN)
(209) 239-4554
Entity
Organization
Contact information
Practice address
200 COTTAGE AVE, SUITE 201, MANTECA, CA 95336-4935
(209) 239-4554
(209) 239-4011
Mailing address
200 COTTAGE AVE, SUITE 201, MANTECA, CA 95336-4935
(209) 239-4554
(209) 239-4011
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
G35573
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G355730
—
CA
Enumeration date
11/15/2007
Last updated
06/17/2008
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