Individual
BRADIN CARTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
711 CANTON RD NE STE 300, MARIETTA, GA 30060
(678) 741-5000
(678) 819-4280
Mailing address
4480H S COBB DR SE # 325, SMYRNA, GA 30080-6958
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
8565
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003202090B
—
GA
Enumeration date
10/19/2017
Last updated
03/19/2020
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