Individual
DR. EDMUND THOMAS CARROLL III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
12100 BLACK SWAN DRIVE, SUITE 201, LEWES, DE 19958-4988
(302) 644-3311
(302) 644-3300
Mailing address
211 EXECUTIVE DR STE 11, NEWARK, DE 19702-3358
(302) 451-6913
(302) 368-7756
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
C20007511
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1000035330
—
DE
01
—
1184681488
COMMERCIAL INSURANCES
—
01
—
204955
UNISON HEALTH PLAN
—
01
—
2129304
ONENET PPO, MAMSI, OPTIMUM CHOICE
—
01
—
2356448000
AMERIHEALTH
—
01
—
3638665
AETNA US HEALTHCARE
—
01
—
51-0343207
BLUE CROSS BLUE SHIELD OF DELAWARE
—
01
—
51-0370286
CORVEL/CORCARE
—
01
—
P00247768
RAILROAD MEDICARE
—
Enumeration date
05/13/2006
Last updated
01/23/2020
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