Provider Demographics
NPI:1932549771
Name:CARROLL, ROBERT M (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:M
Last Name:CARROLL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2701 HOLME AVE STE 303
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19152-2029
Mailing Address - Country:US
Mailing Address - Phone:215-335-3088
Mailing Address - Fax:215-335-0315
Practice Address - Street 1:2701 HOLME AVE STE 303
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19152
Practice Address - Country:US
Practice Address - Phone:215-335-3088
Practice Address - Fax:215-335-0315
Is Sole Proprietor?:No
Enumeration Date:2013-06-25
Last Update Date:2019-06-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMD460367207W00000X, 207WX0107X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology