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General NPI Number Information
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NPI Number | 1619764834
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Entity Type | Organization
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Legal Business Name | CARROLL HEALTH GROUP, LLC
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Dates
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Enumeration Date | 04/22/2025
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Last Update Date | 04/22/2025
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Provider Practice Location Address
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Address Line | 1380 PROGRESS WAY STE 107
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City | ELDERSBURG
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State | MD
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Zip | 21784-6498
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Country | US
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Telephone | 410-443-2893
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 45962
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City | BALTIMORE
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State | MD
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Zip | 21297-5962
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Country | US
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Telephone | 410-469-4269
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Fax | 410-469-4160
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Authorized Official
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Title or Position | CFO CHC
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Name | MICHAEL MYERS
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Credential |
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Telephone | 410-871-6114
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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