Individual
KELLY DUANE CARTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
619 N COVE BLVD, PANAMA CITY, FL 32401-3642
(850) 804-3870
Mailing address
619 N COVE BLVD, PANAMA CITY, FL 32401-3642
(850) 804-3870
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
20711
AL
208000000X
Pediatrics Physician
C54560
CA
208000000X
Pediatrics Physician
Primary
ME149464
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000035556
—
AL
01
—
35556
BLUE CROSS BLUE SHIELD
AL
05
—
C54560
—
CA
Enumeration date
09/14/2006
Last updated
09/02/2021
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