CARROLL MEDICAL GROUP NPI 1730420811

NPI Information

  • NPI: 1730420811
  • Provider Name: CARROLL MEDICAL GROUP
  • Classification: Physician Assistant - 363AM0700X
  • Specialization: Medical
  • Entity Type: Organization
  • Doing Business As: LIFEBRIDGE COMMUNITY PHYSICIAN
  • CLIA Number: 21D0215137
  • Address: 4231 N WOODS TRL
    HAMPSTEAD, MD
    ZIP 21074
  • Phone: (410) 374-9391

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NPI Details

CARROLL MEDICAL GROUP is a medical physician assistant in Hampstead, MD. CARROLL MEDICAL GROUP NPI is 1730420811. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Lifebridge Community Physician.

The provider's business location address is:

4231 N WOODS TRL
HAMPSTEAD, MD
ZIP 21074-128
Phone: (410) 374-9391
Fax: (410) 374-1866

The provider's authorized official is Karen Ann Barrett .
The authorized official title is Office Manager and has the following contact phone number (410) 374-9391.

The CLIA number assigned to this NPI record is 21D0215137 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 3/14/2013 and was last updated on 3/14/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363AM0700XPhysician AssistantMedicalC0005012MARYLANDYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1C0005012OTHERMARYLANDLICENSE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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