MEDICARE: CARROLL HEALTH GROUP, LLC

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
1	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1225822794
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CARROLL HEALTH GROUP, LLC

Provider Business Mailing Address
First Line	:	200 MEMORIAL AVE
Second Line	:
City	:	WESTMINSTER
State	:	MD
Zip	:	21157-5726
Country	:	US
Telephone Number	:	410-871-6864
Fax Number	:	410-871-6516

Provider Business Practice Location Address
First Line	:	504 E RIDGEVILLE BLVD STE 110
Second Line	:
City	:	MOUNT AIRY
State	:	MD
Zip	:	21771-5942
Country	:	US
Telephone Number	:	301-829-5906
Fax Number	:

Authorized Official
Title or Position	:	CFO CHC
Name	:	MICHAEL MYERS
Credential	:
Telephone Number	:	410-871-6114

Provider Enumeration Date	:	04/08/2025
Last Update Date	:	03/10/2026

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