Individual
MARION CARROLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
11100 EUCLID AVE, CLEVELAND, OH 44106
(216) 844-1000
Mailing address
1020 HOMEWOOD DR, LAKEWOOD, OH 44107-1420
(216) 228-6526
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
35060690
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000212469
UNISON
OH
01
—
000000379823
ANTHEM
OH
01
—
000000503545
ANTHEM
OH
05
—
0823238
—
OH
01
—
363398
WELLCARE MEDICAID
OH
01
—
4405802
AETNA
OH
01
—
742629
BUCKEYE MEDICAID
OH
01
—
N363376
WELLCARE
OH
01
—
P00382874
RAILROAD MEDICARE
OH
Enumeration date
04/10/2006
Last updated
11/18/2009
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