Provider Demographics
NPI:1235897836
Name:CARROLL, MAURICE
Entity Type:Individual
Prefix:MR
First Name:MAURICE
Middle Name:
Last Name:CARROLL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:440 E OLIVER ST APT 3C
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21202-3075
Mailing Address - Country:US
Mailing Address - Phone:410-900-8067
Mailing Address - Fax:
Practice Address - Street 1:440 E OLIVER ST APT 3C
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21202-3075
Practice Address - Country:US
Practice Address - Phone:410-900-8067
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-01
Last Update Date:2021-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health