Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204E00000X | Oral & Maxillofacial Surgeon | 0401008299 | VA |
N | 204E00000X | Oral & Maxillofacial Surgeon | DN6002 | FL |
Y | 204E00000X | Oral & Maxillofacial Surgeon | NC3265 | NC |
NPI | 1447364666 |
---|---|
Provider Name | Dr. Dewey G Carter |
First Address | Burlington, NC 27215-6288 |
Second Address | Burlington, NC 27215-6288 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/08/2006 |
Last Update Date | 01/11/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
8991414 | (05) | NC |
91414 | BCBS (01) | NC |
T63792 | (02) |