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Individual

SHAWN L CARTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1000 JOHNSON FERRY RD NE, ATLANTA, GA 30342-1606
(404) 851-6936
Mailing address
PO BOX 2968, KENNESAW, GA 30156-9117
(770) 779-0015

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
056419
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
10041967
AMERIGROUP
GA
01
11192
KAISER
GA
01
196608
BCBS OF GEORGIA
GA
01
198018
BCBS OF GEORGIA
GA
01
333400
WELLCARE OF GEORGIA
GA
05
343262912A
GA
05
343262912B
GA
Enumeration date
02/15/2006
Last updated
11/08/2008
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