Healthcare Provider Details

I. General information

NPI: 1750579074
Provider Name (Legal Business Name): MORNINGSTAR & CARROLL PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/11/2007
Last Update Date: 11/20/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

310 S SETON AVE
EMMITSBURG MD
21727-9227
US

IV. Provider business mailing address

PO BOX 309
EMMITSBURG MD
21727-0309
US

V. Phone/Fax

Practice location:
  • Phone: 301-447-6155
  • Fax: 301-447-3289
Mailing address:
  • Phone: 301-447-6155
  • Fax: 301-447-3289

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberD0018705
License Number StateMD

VIII. Authorized Official

Name: DR. ALAN LEE CARROLL
Title or Position: PRESIDENT
Credential: M.D.
Phone: 301-447-6156