BRYAN CARROLL


Address: 721 Fairfax Ave, Ste 200, Norfolk, VA 23507-2007
Phone: 7574465629

BRYAN CARROLL (NPI# 1609087121) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1609087121
Entity Type Individual
Full Name BRYAN CARROLL
Credential M.D.
Practice Address 721 Fairfax Ave
Ste 200
Norfolk
VA 23507-2007
Mailing Address 11100 Euclid Ave
Cleveland
OH 44106-1716
Practice Telephone 7574465629
Practice Fax Number 7574466000
Mailing Telephone 2168441000
Enumeration Date 2007-05-25
Last Update Date 2019-07-16
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 207N00000X Dermatology 0101252291 VA Allopathic & Osteopathic Physicians
Y 207N00000X Dermatology 35.137019 OH Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
VA ANTHEM BC/BS 473606 01
VA CORVEL PAR 01
VA AETNA PAR 01
VA TRICARE/CHAMPUS -005 01
NC 5921028 05
VA COVENTRY HEALTH NETWORK 1609087121 01
VA MULTIPLAN PAR 01
VA UNITED HEALTHCARE 1609087121 01
VA 1609087121 05
VA USA MANAGED CARE PAR 01
VA OPTIMA HEALTH 10097097 01
VA CIGNA PAR 01
VA VIRGINIA PREMIER HEALTH PLAN 1609087121 01
VA VIRGINIA HEALTH NETWORK PAR 01

Other Providers BRYAN CARROLL

NPI Name Taxonomy Address Enumeration
1134486582 Bryan J Carroll Dermatology 901 7th Ave, Fort Worth, TX 76104-2722 2012-04-23

Office Location

Street Address 721 FAIRFAX AVE
STE 200
City NORFOLK
State VA
Zip Code 23507-2007

Providers in the same location

NPI Name Taxonomy Address Enumeration
1245237791 Beverly Lavern Roberts-atwater Physical Medicine & Rehabilitation 721 Fairfax Ave, 3rd Floor, Norfolk, VA 23507-2007 2005-06-30
1477161610 Alyssa Joyce Jessup Nurse Practitioner 721 Fairfax Ave, Norfolk, VA 23507-2007 2020-07-14
1285253500 Emily Ruth Cunningham Student in an Organized Health Care Education/Training Program 721 Fairfax Ave, Norfolk, VA 23507-2007 2020-04-16
1043872005 Zahra Tasneem Student in an Organized Health Care Education/Training Program 721 Fairfax Ave, Norfolk, VA 23507-2007 2019-06-30
1508427741 Reema Husni Abughoush Student in an Organized Health Care Education/Training Program 721 Fairfax Ave, Norfolk, VA 23507-2007 2019-06-27
1891350443 Stephan Duran Student in an Organized Health Care Education/Training Program 721 Fairfax Ave, Norfolk, VA 23507-2007 2019-05-08
1396208500 Kelly Starosta Hill Student in an Organized Health Care Education/Training Program 721 Fairfax Ave, Norfolk, VA 23507-2007 2019-04-14
1205396884 Zeeshan Toor Student in an Organized Health Care Education/Training Program 721 Fairfax Ave, Norfolk, VA 23507-2007 2019-03-21
1861952434 Steve Mark D'souza Student in an Organized Health Care Education/Training Program 721 Fairfax Ave, Norfolk, VA 23507-2007 2019-03-20
1932668738 Abigail Winz Student in an Organized Health Care Education/Training Program 721 Fairfax Ave, Norfolk, VA 23507-2007 2019-03-19
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1790306801 Paolo Quentin Rigo Student in an Organized Health Care Education/Training Program Smith Rogers Hall, 358 Mowbray Arch, Suite #203/205, Norfolk, VA 23507 2020-04-29
1811526221 Sean M Whitty Student in an Organized Health Care Education/Training Program Emergency Medicine Residency, Raleigh Building, St 304, 600 Gresham Dr, Norfolk, VA 23507 2020-04-07
1962030643 Shekinah Joy Vaughn Student in an Organized Health Care Education/Training Program 385 Mowbray Arch Ste 203205, Norfolk, VA 23507 2020-03-30
1982231403 Jaxon Vallely Student in an Organized Health Care Education/Training Program 358 Mowbray Arch, Suite #203/205, Norfolk, VA 23507 2020-03-25
1437714656 Kanishk Deep Sharma Student in an Organized Health Care Education/Training Program 825 Fairfax Avenue Eastern Virginia Medical School Inte, Suite 445, Norfolk, VA 23507 2019-05-02
1619439460 Dylan Woolum Student in an Organized Health Care Education/Training Program Raleigh Building, Suite 304, 600 Gresham Drive, Norfolk, VA 23507 2019-04-02
1477012623 Jessie R Jones Student in an Organized Health Care Education/Training Program 825 Fairfax Ave Ste 513a, Norfolk, VA 23507 2019-03-18
1316416787 Lindsey Sawyer Genetic Counselor, MS Childrens Hospital of The Kings Daughters, 601 Childrens Lane, Norfolk, VA 23507 2018-11-15
1881188159 Patrick Michael Haar Pharmacist 601 Pembroke Avenue, Apt 104, Norfolk, VA 23507 2018-06-19
1316438377 Monika Pajhal Student in an Organized Health Care Education/Training Program Eastern Virginia Medical School (internal Medicine), Internal Medicine, 825 Fairfax Ave, Suite 410, Norfolk, VA 23507 2018-05-25
Find all providers in zip 23507

Taxonomy Information

Taxonomy Code 207N00000X
Grouping Allopathic & Osteopathic Physicians
Classification Dermatology

Taxonomy Definition

A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1932582467 Anh Khoa Pham Dermatology 850 Kempsville Rd Ste 100d, Norfolk, VA 23502-3920 2015-07-01
1801238472 Integrated Dermatology of Tidewater LLC Dermatology 885 Kempsville Rd Ste 309, Norfolk, VA 23502-3800 2013-07-24
1144575473 Kmn Dermatology & Aesthetics PC Dermatology 146 Main St, Ste 2b, Norfolk, MA 02056-1322 2012-07-24
1326363292 Bruce Daniel Bauer Dermatology 6160 Kempsville Cir Ste 200a, Norfolk, VA 23502-3945 2010-04-02
1164495115 Brian L Johnson Dermatology 5630 Lowery Rd, Norfolk, VA 23502-2233 2006-02-09
1003887118 Evms Academic Physicians and Surgeons Health Services Foundation Dermatology 4111 Monarch Way, Suite 500, Norfolk, VA 23508-2559 2006-01-27
1184076796 Robert James Smith Dermatology 721 Fairfax Ave Ste 200, Norfolk, VA 23507-2007 2016-07-07
1912351032 Andrew Raul Villanueva Dermatology 721 Fairfax Ave Ste 200, Norfolk, VA 23507-2007 2016-04-14
1760845986 Adelaida Gyurjyan-bunch Dermatology 6160 Kempsville Cir Ste 200a, Norfolk, VA 23502-3945 2016-04-04
1780932129 Natalia Mendoza Dermatology 6160 Kempsville Cir Ste 200a, Norfolk, VA 23502-3945 2012-08-15
Find all providers in NORFOLK

Competitor

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City NORFOLK
Zip Code 23507

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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