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Organization

CARROLL MEDICAL GROUP

Active
Other names
LifeBridge Community Physician
Organization subpart
No

Provider details

NPI number
Authorized official
KAREN ANN BARRETT MA (OFFICE MANAGER)
(410) 374-9391
Entity
Organization

Contact information

Practice address
4231 N WOODS TRL, HAMPSTEAD, MD 21074-3128
(410) 374-9391
(410) 374-1866
Mailing address
4231 N WOODS TRL, HAMPSTEAD, MD 21074-3128
(410) 374-9391
(410) 374-1866

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
C0005012
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
C0005012
LICENSE
MD
Enumeration date
03/14/2013
Last updated
03/14/2013
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