Individual
AVIANCE BIANCA CARTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
301 SOUTH 8TH STREET, THE GARFIELD DUNCAN BUILDING, STE. 2C, PHILADELPHIA, PA 19106-4017
(215) 829-5022
(215) 829-5060
Mailing address
301 SOUTH 8TH STREET, THE GARFIELD DUNCAN BUILDING, STE. 2C, PHILADELPHIA, PA 19106-4017
(215) 829-5022
(215) 829-5060
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
MA059051
PA
363AS0400X
Surgical Physician Assistant
Primary
MA059051
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MA059051
STATE LICENSE NUMBER
PA
Enumeration date
06/21/2017
Last updated
08/29/2019
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