Carter, Russell P

Carter, Russell P is an individual health care provider with primary practice located at 200 Cottage Ave Suite 201, Manteca CA 95336. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Carter, Russell P can be contacted via phone (209) 239-4554.

Contact Information

Primary practice address
200 Cottage Ave Suite 201 Manteca CA 95336
Phone: (209) 239-4554
Fax: (209) 239-4011
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X G35573 California

Profile Details

NPI number 1528049988
LBN Legal business name Carter, Russell P
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 10th, 2005
Last updated Oct 25th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1528049988 NPPES
California MEDICAID 00G355730

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