Individual
CAROL D COLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
410 W LINFIELD TRAPPE RD, 240, LIMERICK, PA 19468-4295
(610) 495-6500
(610) 495-6558
Mailing address
410 W LINFIELD TRAPPE RD, 240, LIMERICK, PA 19468-4295
(610) 495-6500
(610) 495-6558
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
OS006160L
PA
207ND0101X
MOHS-Micrographic Surgery Physician
4575
OK
207NS0135X
Procedural Dermatology Physician
4575
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01720128
RAILROAD MEDICARE
PA
01
—
0452366000
INDEPENDENCE BLUE CROSS
PA
05
—
100749090B
—
OK
01
—
1014066
KEYSTONE MERCY
PA
01
—
451708
AETNA
PA
01
—
50018326
CAPITOL BLUE CROSS
PA
01
—
622829
HIGHMARK BLUE SHIELD
PA
Enumeration date
03/30/2006
Last updated
06/13/2013
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