Carroll, Brendan Cargill

Carroll, Brendan Cargill is an individual health care provider with primary practice located at 4805 Ne Glisan St Unit 3K, Portland OR 97213-2933. He recently has only one registered license in Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, which is considered as his primary health care specialty. Carroll, Brendan Cargill can be contacted via phone (503) 215-6150.

Contact Information

Primary practice address
4805 Ne Glisan St Unit 3K Portland OR 97213-2933
Phone: (503) 215-6150
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X MD21047 Oregon

Profile Details

NPI number 1669472775
LBN Legal business name Carroll, Brendan Cargill
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 29th, 2005
Last updated Feb 18th, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1669472775 NPPES
Oregon MEDICAID 130056

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