Individual
EBONI X CARTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2929 LONDON BLVD, PORTSMOUTH, VA 23707-3405
(757) 861-9010
(757) 861-9011
Mailing address
2929 LONDON BLVD, PORTSMOUTH, VA 23707-3405
(757) 861-9010
(757) 861-9011
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101236065
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010071216
—
VA
01
—
143466
ANTHEM
VA
01
—
78032
SENTARA/OPTIMA
VA
Enumeration date
02/08/2006
Last updated
02/18/2025
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