Provider Demographics
NPI:1538250386
Name:CARRERA, EDUVIGIS (MD)
Entity type:Individual
Prefix:
First Name:EDUVIGIS
Middle Name:
Last Name:CARRERA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:69 GREYABBEY DR
Mailing Address - Street 2:
Mailing Address - City:PINEHURST
Mailing Address - State:NC
Mailing Address - Zip Code:28374-6705
Mailing Address - Country:US
Mailing Address - Phone:772-538-8307
Mailing Address - Fax:
Practice Address - Street 1:69 GREYABBEY DR
Practice Address - Street 2:
Practice Address - City:PINEHURST
Practice Address - State:NC
Practice Address - Zip Code:28374-6705
Practice Address - Country:US
Practice Address - Phone:772-538-8307
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-27
Last Update Date:2025-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME82240207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL100287800Medicaid