Provider Demographics
NPI:1346338324
Name:CARROLL, MICHAEL F (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:F
Last Name:CARROLL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:6227 FRANKFORT HWY
Mailing Address - Street 2:
Mailing Address - City:BENZONIA
Mailing Address - State:MI
Mailing Address - Zip Code:49616-8632
Mailing Address - Country:US
Mailing Address - Phone:231-882-9661
Mailing Address - Fax:231-882-1049
Practice Address - Street 1:4025 CHUMS VILLAGE DR
Practice Address - Street 2:
Practice Address - City:TRAVERSE CITY
Practice Address - State:MI
Practice Address - Zip Code:49685-6992
Practice Address - Country:US
Practice Address - Phone:231-642-5560
Practice Address - Fax:231-642-5563
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2020-10-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI4301077554207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine