Individual
SAMUEL R CARTER III
Active
Individual
SAMUEL R CARTER III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
109788
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100069440A
—
OK
05
—
100188880A
—
KS
01
—
110136988
RR MEDICARE
—
05
—
208238105
—
MO
01
—
31655
ANTHEM
MO
Enumeration date
06/22/2006
Last updated
08/28/2023
Update your record
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