Individual
DR. LARRY CARROLL
Active
Individual
DR. LARRY CARROLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
MI43050397
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0829560001
MEDICARE DME
MI
01
—
0C16002
MEDICARE GROUP
MI
05
—
104362017
—
MI
01
—
LC050397
BLUECROSS STATE ID
MI
Enumeration date
05/19/2006
Last updated
11/23/2009
Update your record
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