Basic Information
Provider Information | |||||||||
NPI: | 1033182274 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | CARTER | ||||||||
FirstName: | FALANA | ||||||||
MiddleName: |   | ||||||||
NamePrefix: |   | ||||||||
NameSuffix: |   | ||||||||
Credential: | MD | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | 1111 BENFIELD BLVD | ||||||||
Address2: | SUITE 200 | ||||||||
City: | MILLERSVILLE | ||||||||
State: | MD | ||||||||
PostalCode: | 211083002 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 4107295100 | ||||||||
FaxNumber: | 4107295156 | ||||||||
Practice Location | |||||||||
Address1: | 7556 TEAGUE RD | ||||||||
Address2: | SUITE 210 | ||||||||
City: | HANOVER | ||||||||
State: | MD | ||||||||
PostalCode: | 210761213 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 4105510499 | ||||||||
FaxNumber: | 4107999070 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 02/08/2006 | ||||||||
LastUpdateDate: | 05/22/2012 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | F | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 0101236510 | VA | N |   | Allopathic & Osteopathic Physicians | Family Medicine |   | 207Q00000X | MD438639 | PA | N |   | Allopathic & Osteopathic Physicians | Family Medicine |   | 207Q00000X | D0071697 | MD | Y |   | Allopathic & Osteopathic Physicians | Family Medicine |   |
ID Information
ID | Type | State | Issuer | Description | 1024046850001 | 05 | PA |   | MEDICAID | 570096500 | 05 | MD |   | MEDICAID | 78107 | 01 | VA | SENTARA/OPTIMA | OTHER | P00940457 | 01 | MD | RAILROAD MEDICARE | OTHER | 010076536 | 05 | VA |   | MEDICAID | 97287601 | 01 | MD | CAREFIRST BCBS OF MD | OTHER | 143575 | 01 | VA | ANTHEM | OTHER | 541595397 | 01 | VA | CIGNA | OTHER | P19620 | 01 | MD | CAREFIRST BCBS POS | OTHER | 244619 | 01 | MD | EHP/PRIORITY PARTNERS | OTHER | 6629079 | 01 | MD | AETNA-HMO | OTHER | 7004609 | 01 | VA | AETNA | OTHER | 541595397 | 01 | VA | VIRGINIA HEALTH NETWORK | OTHER | 0115 | 01 | MD | CAREFIRST BCBS BLUECHOICE | OTHER | 541595397 | 01 | VA | TRICARE | OTHER | 7004609 | 01 | MD | AETNA PPO | OTHER |