Individual
DR. KEVIN R CARTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
50 N PERRY ST, PONTIAC, MI 48342-2217
(248) 338-5604
Mailing address
200 OCEANGATE, SUITE 100, LONG BEACH, CA 90802-4317
(562) 499-6191
(562) 499-6171
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
5101015589
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1659422749
—
MI
01
—
300F361250
BCBS OF MI GROUP
MI
01
—
CA3518
MEDICARE RR GROUP PIN / PALMETO GBA
MI
01
—
P00737290
RRMC
MI
Enumeration date
01/15/2007
Last updated
10/24/2019
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