Individual
MICHAEL W CARTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
200 CARROLL ST, ST PAUL, KS 66771-4044
(620) 449-2582
(620) 449-2587
Mailing address
200 CARROLL ST, ST PAUL, KS 66771-4044
(620) 449-2582
(620) 449-2587
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
15-00512
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100362330B
—
KS
01
—
42591
BCBS
KS
Enumeration date
07/11/2005
Last updated
01/21/2011
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