Healthcare Provider Details

I. General information

NPI: 1497861744
Provider Name (Legal Business Name): CAROL L NOALL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/21/2006
Last Update Date: 02/25/2021
Certification Date: 02/25/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

510 FIFTH AVENUE
CHARDON OH
44024
US

IV. Provider business mailing address

PO BOX 714328
COLUMBUS OH
43271-4328
US

V. Phone/Fax

Practice location:
  • Phone: 440-285-9494
  • Fax: 440-285-5016
Mailing address:
  • Phone: 800-354-1985
  • Fax: 440-350-4938

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number35-070235
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: