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Individual

ELISA M CARTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
100 PLANK BRIDGE RD, CAMDEN, NC 27921
(252) 331-1829
(252) 331-2916
Mailing address
PO BOX 11314, BELFAST, ME 04915-4004
(757) 842-4481
(757) 312-3135

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
0110001676
VA
363AM0700X
Medical Physician Assistant
Primary
0110001676
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
010385407
VA
Enumeration date
08/05/2006
Last updated
11/19/2020
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