Healthcare Provider Details

I. General information

NPI: 1043240708
Provider Name (Legal Business Name): CARROLL FAMILY MEDICINE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/05/2006
Last Update Date: 03/14/2025
Certification Date: 03/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

814 HOUCKSVILLE RD
HAMPSTEAD MD
21074-1882
US

IV. Provider business mailing address

814 HOUCKSVILLE RD
HAMPSTEAD MD
21074-1882
US

V. Phone/Fax

Practice location:
  • Phone: 410-239-0406
  • Fax: 410-239-0407
Mailing address:
  • Phone: 410-239-0406
  • Fax: 410-239-0407

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. PETER G UGGOWITZER
Title or Position: PRESIDENT/OWNER
Credential: M.D.
Phone: 410-239-0406