Individual
DR. NICOLE DUPRAW CARTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
301 MEDICAL DR STE 504, LAGRANGE, GA 30240-4172
(706) 812-2655
Mailing address
301 MEDICAL DR STE 504, LAGRANGE, GA 30240-4172
(706) 812-2655
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
25967
AL
208000000X
Pediatrics Physician
Primary
54982
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009962405
—
AL
05
—
009962415
—
AL
01
—
25967
ALABAMA CONTR SUBST CERT
AL
01
—
37544
AMERICAN BOARD PEDIATRICS
—
01
—
515-22781
BCBS AL PROV # OPELIKA
AL
01
—
515-22782
BCBS AL PROV # AUBURN
AL
01
—
54982
GEORGIA MEDICAL LICENSE
GA
01
—
926662
AAP ID
—
Enumeration date
02/12/2007
Last updated
08/17/2024
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