Dr. Chase Mitchell Carroll, M.D.
Internal Medicine in Indianapolis, IN. Individual provider (NPI-1).
NPI number1376957878
StatusActive
Last updated in NPPESJan 4, 2021
Details
- NPI
- 1376957878
- Entity type
- Individual (NPI-1)
- Name
- Dr. Chase Mitchell Carroll
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jun 12, 2014
- Certification date
- Jan 4, 2021
- Last updated
- Jan 4, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207R00000X | Internal Medicine | 01079481A | IN | Yes |
| 390200000X | Student in an Organized Health Care Education/Training Program | 11017789A | IN |
Practice location
1481 W 10th St # C-7033Indianapolis, IN 46202-2803
Phone 765-617-9387 · Fax 317-988-5648
Mailing address
1481 W 10th St # C-7033Indianapolis, IN 46202-2803
Phone 765-617-9387 · Fax 317-988-5648
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