Individual
MARIA C CARROLL
Active
Individual
MARIA C CARROLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
4301077553
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
070010119
RAILROAD MEDICARE
MI
01
—
0702803192
BLUE CROSS BLUE SHIELD
MI
01
—
38-2170687
PRIORITY HEALTH
MI
05
—
4317989
—
MI
01
—
M008816
TRICARE
—
Enumeration date
08/30/2006
Last updated
06/04/2013
Update your record
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