Individual
MARK CARROLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2829 E HIGHWAY 76, MULLINS, SC 29574-6035
(843) 497-5929
(843) 497-9940
Mailing address
4615 OLEANDER DR, MYRTLE BEACH, SC 29577-5741
(843) 497-5929
(843) 497-9940
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
23336
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8921427
—
NC
05
—
N39925
—
SC
01
—
P00125463
RAILROAD MEDICARE
—
Enumeration date
07/07/2005
Last updated
01/17/2008
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