MEDICARE: MARY E CARROLL MD & ASSOCIATES PA

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	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1811143464
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MARY E CARROLL MD & ASSOCIATES PA

Provider Business Mailing Address
First Line	:	9110 PHILADELPHIA RD
Second Line	:	STE 108
City	:	ROSEDALE
State	:	MD
Zip	:	21237-4301
Country	:	US
Telephone Number	:	410-574-8440
Fax Number	:	410-574-8072

Provider Business Practice Location Address
First Line	:	9110 PHILADELPHIA RD
Second Line	:	STE 108
City	:	ROSEDALE
State	:	MD
Zip	:	21237-4301
Country	:	US
Telephone Number	:	410-574-8440
Fax Number	:	410-574-8072

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	EVA A. ADAMS
Credential	:
Telephone Number	:	410-574-3655

Provider Enumeration Date	:	08/14/2008
Last Update Date	:	09/19/2013

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