Provider Demographics
NPI:1730168014
Name:CARTER, LESLIE ANN (MD)
Entity type:Individual
Prefix:DR
First Name:LESLIE
Middle Name:ANN
Last Name:CARTER
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:325 SW UPPER TERRACE DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97702-1900
Mailing Address - Country:US
Mailing Address - Phone:541-330-0900
Mailing Address - Fax:541-312-5739
Practice Address - Street 1:325 SW UPPER TERRACE DR
Practice Address - Street 2:SUITE 100
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97702-1900
Practice Address - Country:US
Practice Address - Phone:541-330-0900
Practice Address - Fax:541-312-5739
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-13
Last Update Date:2023-02-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
ORMD25131207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
I17881Medicare UPIN