Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 125055836 | IL |
N | 208600000X | Surgeon | 125055836 | IL |
N | 208200000X | Surgeon | 54426 | KY |
N | 208600000X | Surgeon | 54426 | KY |
N | 2086S0102X | Surgical Critical Care | 54426 | KY |
N | 2086S0120X | Pediatric Surgery | 35124 | AL |
Y | 2086S0120X | Pediatric Surgery | 54426 | KY |
N | 2086S0120X | Pediatric Surgery | TP321 | KY |
NPI | 1215164025 |
---|---|
Provider Name | Dr. Stewart Reddin Carter |
First Address | Chicago, IL 60677-6879 |
Second Address | Louisville, KY 40202-1713 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/06/2009 |
Last Update Date | 07/01/2021 |