MEDICARE: MCCARROLL PRIMARY CARE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	BM007710	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	104279	OTHER	MI	CARE CHOICES
2	124180	OTHER	MI	GREAT LAKES HEALTH PLAN
3	0154410164	OTHER	MI	BCBS
4	C8031	OTHER	MI	M-CARE
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1528130051
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MCCARROLL PRIMARY CARE

Provider Business Mailing Address
First Line	:	P.O. BOX 687
Second Line	:
City	:	ALMONT
State	:	MI
Zip	:	48003
Country	:	US
Telephone Number	:	810-798-6560
Fax Number	:

Provider Business Practice Location Address
First Line	:	198 N. MAIN ST
Second Line	:
City	:	ALMONT
State	:	MI
Zip	:	48003
Country	:	US
Telephone Number	:	810-798-6560
Fax Number	:

Authorized Official
Title or Position	:	OWNER-PHYSICIAN
Name	:	BRIAN A MCCARROLL
Credential	:	D.O.
Telephone Number	:	810-798-6560

Provider Enumeration Date	:	11/13/2006
Last Update Date	:	08/22/2020

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Directions to “MCCARROLL PRIMARY CARE ” Practice Location

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