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Individual
PAUL J CARROLL
Active
Individual
PAUL J CARROLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
685
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0065PA
—
SC
Enumeration date
12/27/2005
Last updated
03/20/2014
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