Individual
KRISTINE MARIE CARTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1340 BROAD AVE, SUITE 240, GULFPORT, MS 39501-2404
(228) 575-1200
(228) 575-1205
Mailing address
PO BOX 1810, GULFPORT, MS 39502-1810
(228) 575-1200
(228) 575-1205
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
024139
LA
208600000X
Surgery Physician
Primary
19450
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09684296
—
MS
05
—
1572284
—
LA
Enumeration date
07/25/2006
Last updated
07/11/2014
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