Provider Demographics
NPI:1124401948
Name:CARROLL, DEVIN CHRISTOPHER (DPM)
Entity Type:Individual
Prefix:DR
First Name:DEVIN
Middle Name:CHRISTOPHER
Last Name:CARROLL
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:171 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SUFFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23434-4507
Mailing Address - Country:US
Mailing Address - Phone:757-934-0768
Mailing Address - Fax:757-925-1901
Practice Address - Street 1:5835 HARBOUR VIEW BLVD STE A
Practice Address - Street 2:
Practice Address - City:SUFFOLK
Practice Address - State:VA
Practice Address - Zip Code:23435-2601
Practice Address - Country:US
Practice Address - Phone:757-384-6617
Practice Address - Fax:757-686-3669
Is Sole Proprietor?:No
Enumeration Date:2015-06-30
Last Update Date:2024-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0103301236213ES0103X, 213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery