Individual
DR. GERARD GREGORI CARROLL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1 COOPER PLZ, CAMDEN, NJ 08103-1461
(856) 968-7433
(856) 968-8499
Mailing address
1 FEDERAL ST # 200, CAMDEN, NJ 08103-1088
(856) 356-4924
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
25MA09092600
NJ
207P00000X
Emergency Medicine Physician
MT195608
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0307513
—
NJ
01
—
MT195608
PA STATE TRAINING LICENSE
PA
Enumeration date
06/03/2009
Last updated
08/26/2020
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