Individual
PENELOPE ANNE CARTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3401 CIVIC CENTER BLVD, PHILADELPHIA, PA 19104
(215) 590-7131
Mailing address
3401 CIVIC CENTER BLVD, PHILADELPHIA, PA 19104-4319
(215) 590-7131
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
MD465085
PA
2084P0804X
Child & Adolescent Psychiatry Physician
MT210583
PA
390200000X
Student in an Organized Health Care Education/Training Program
MT210583
PA
Other
Enumeration date
04/05/2016
Last updated
07/14/2021
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