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Individual

CODY GARRETT CARPENTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
501 S SHARON AMITY RD STE 300, CHARLOTTE, NC 28211-0035
(704) 377-2424
(704) 377-2687
Mailing address
501 S SHARON AMITY RD STE 300, CHARLOTTE, NC 28211-0035
(704) 377-2424
(704) 377-2687

Taxonomy

Speciality
Code
Description
License number
State
207PP0204X
Pediatric Emergency Medicine (Emergency Medicine) Physician
Primary
2012-00810
NC
208000000X
Pediatrics Physician
TL30225
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
171J0
BCBS
NC
05
302256
SC
05
59-21309
NC
Enumeration date
01/04/2007
Last updated
11/28/2018
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