| Doctor Name: | MICHAEL J CARROLL |
| NPI Number: | 1235304205 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PA |
| License Number: | 101656 |
| Business Practice Address: | 110 E Wall St Rural Hall, NC - 270459312 |
| Business Phone Number: | 3366599440 |
| Business Fax Number: | 3366599845 |
| Mailing Address: | 110 E Wall St, RURAL HALL |
| State: | NC |
| Postal Code: | 270459312 |
| Phone Number: | 3366599440 |
| Fax Number: | 3366599845 |
| NPI Enumeration Date: | 04/29/2008 |
| NPI Last Update Date: | 11/10/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | 101656 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NC |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |