Individual
MARK O CARTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
164 BRACKEN PKWY, HOBART, IN 46342-6789
(219) 942-1145
(219) 942-8175
Mailing address
9660 WICKER AVENUE, ST JOHN, IN 46373-9487
(219) 226-2203
(219) 226-2202
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01036415A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00000092031
ANTHEM
IN
05
—
100215600A
—
IN
Enumeration date
06/23/2006
Last updated
07/29/2010
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