| Russell P Carter Jr Md Inc | |
|
200 Cottage Ave Suite 201 Manteca CA 95336-4935 | |
| (209) 239-4554 | |
| (209) 239-4011 |
| Full Name | Russell P Carter Jr Md Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 200 Cottage Ave, Manteca, California |
| Authorized Official Name and Position | Russell Philip Carter (PRESIDENT/PHYSICIAN) |
| Authorized Official Contact | 2092394554 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Russell P Carter Jr Md Inc 200 Cottage Ave Suite 201 Manteca CA 95336-4935 Ph: (209) 239-4554 | Russell P Carter Jr Md Inc 200 Cottage Ave Suite 201 Manteca CA 95336-4935 Ph: (209) 239-4554 |
| NPI Number | 1841471166 |
|---|---|
| Provider Enumeration Date | 11/15/2007 |
| Last Update Date | 06/17/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841471166 | NPI | - | NPPES |
| 00G355730 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | G35573 (California) | Primary |
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