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Individual

JENNIFER H CARTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
710 DEWITT DR, LUGOFF, SC 29078-9069
(803) 438-7566
(803) 438-4371
Mailing address
PO BOX 1259, SENTINEL HEALTH PARTNERS PA BUSINESS OFFICE, CAMDEN, SC 29021-1259
(803) 713-8350
(803) 713-8433

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
1128
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0477PA
SC
01
192417
MEDCOST PIN
01
P00371643
RAILROAD MEDICARE PIN
SC
Enumeration date
09/13/2006
Last updated
08/26/2013
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