Carroll, William David
Carroll, William David is an individual health care provider with primary practice located at 3536 Mendocino Ave 300, Santa Rosa CA 95403-3634. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Geriatric Medicine. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Carroll, William David can be contacted via phone (707) 546-2180.Contact Information
Primary practice address
3536 Mendocino Ave 300
Santa Rosa CA 95403-3634
Phone: (707) 546-2180
Fax: (707) 546-2188
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | A39947 | California |
Allopathic & Osteopathic Physicians / Geriatric Medicine | 207RG0300X | A39947 | California |
Profile Details
NPI number | 1922005891 |
---|---|
LBN Legal business name | Carroll, William David |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Jul 6th, 2005 |
Last updated | Feb 7th, 2012 - about 12 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1922005891 | NPPES |
California | Other | 00A399470 | BLUE SHIELD OF CALIFORNIA |
California | MEDICAID | 00A399470 | BLUE SHIELD OF CALIFORNIA |
California | Other | 110105821 | BLUE SHIELD OF CALIFORNIA |
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