Individual
LESLIE SETON CARROLL
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3401 N BROAD STREET, PHILADELPHIA, PA 19140
(215) 707-5030
(215) 707-3494
Mailing address
PO BOX 828065, PHILADELPHIA, PA 19182-8065
(800) 666-2455
(610) 617-6280
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD047801L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0013974850005
—
PA
01
—
0572020000
INDEPENDENCE BC
PA
01
—
729722
HIGHMARK BS
PA
Enumeration date
03/14/2006
Last updated
07/08/2007
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