Individual
NICHOLAS ROBERT CARTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1130 W MICHIGAN ST # FH204, INDIANAPOLIS, IN 46202-5209
(317) 274-0076
(317) 274-0256
Mailing address
1130 W MICHIGAN ST # FH204, INDIANAPOLIS, IN 46202-5209
(317) 274-0076
(317) 274-0256
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
01089833A
IN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1104203827
ANTHEM PTAN
IN
05
—
300039435
—
IN
Enumeration date
03/31/2020
Last updated
11/25/2024
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