Individual
STACEY M CARTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
234 GOODMAN ST, CINCINNATI, OH 45219-2364
(513) 558-5281
(513) 558-5791
Mailing address
PO BOX 636256, CINCINNATI, OH 45263-6256
(513) 245-3600
(513) 245-3672
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
018743
NY
363A00000X
Physician Assistant
Primary
50.005083RX
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04247123
—
NY
Enumeration date
07/07/2015
Last updated
07/21/2022
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