Provider Demographics
NPI:1912959420
Name:HARROLD, CAROL R (MD)
Entity Type:Individual
Prefix:DR
First Name:CAROL
Middle Name:R
Last Name:HARROLD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1227 PEPPERTREE DR
Mailing Address - Street 2:
Mailing Address - City:MONTROSE
Mailing Address - State:CO
Mailing Address - Zip Code:81401-5658
Mailing Address - Country:US
Mailing Address - Phone:412-616-8878
Mailing Address - Fax:412-616-8878
Practice Address - Street 1:2377 ROBINS WAY
Practice Address - Street 2:
Practice Address - City:MONTROSE
Practice Address - State:CO
Practice Address - Zip Code:81401-5901
Practice Address - Country:US
Practice Address - Phone:970-252-0522
Practice Address - Fax:970-252-0166
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2017-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD432479207R00000X
CODR0056972207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO29817528Medicaid
PA102073401Medicaid
G12310Medicare UPIN