Carballo, Mauricio Daniel
Carballo, Mauricio Daniel is an individual health care provider with primary practice located at 75 Sylvania Dr , Beavercreek OH 45440-3237. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Gastroenterology. Allopathic & Osteopathic Physicians / Gastroenterology is his primary health care specialty. Carballo, Mauricio Daniel can be contacted via phone (937) 320-5050.Contact Information
Primary practice address
75 Sylvania Dr
Beavercreek OH 45440-3237
Phone: (937) 320-5050
Fax: (937) 320-5060
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 125055640 | Illinois |
| Allopathic & Osteopathic Physicians / Gastroenterology | 207RG0100X | 075967 | Georgia |
| Allopathic & Osteopathic Physicians / Gastroenterology | 207RG0100X | 35.138586 | Ohio |
Profile Details
| NPI number | 1508173568 |
|---|---|
| LBN Legal business name | Carballo, Mauricio Daniel |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 10th, 2010 |
| Last updated | Jun 26th, 2020 - about 5 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 | 1508173568 | NPPES |
| Ohio | MEDICAID | 0396368 |
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