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NPI Code Detail

MEDICARE: DR. CHERYL CARROLL M.D.

MEDICARE: DR. CHERYL CARROLL M.D.
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
1208000000XPediatrics Physician025731GA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1025731OTHERGAGEORGIA LICENSE NUMBER

General Provider Information

NPI Number : 1043306194
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CHERYL CARROLL M.D.
Provider Business Mailing Address
First Line : 2416 CAPSTONE CT
Second Line :
City : COLUMBUS
State : GA
Zip : 31909-2795
Country : US
Telephone Number : 706-327-1281
Fax Number : 706-327-1159
Provider Business Practice Location Address
First Line : 2416 CAPSTONE CT
Second Line :
City : COLUMBUS
State : GA
Zip : 31909-2795
Country : US
Telephone Number : 706-327-1281
Fax Number : 706-327-1159
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/05/2006
Last Update Date : 03/07/2023

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