Basic Information
Provider Information
NPI: 1235227091
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CARAVALHO
FirstName: JOSEPH
MiddleName:  
NamePrefix:  
NameSuffix: JR.
Credential: MD
OtherOrganizationName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2817 REILLY ROAD
Address2: WOMACK ARMY MEDICAL CENTER MCXC COD CREDENTIALS
City: FORT BRAGG
State: NC
PostalCode: 28310
CountryCode: US
TelephoneNumber: 9109078922
FaxNumber: 9109076069
Practice Location
Address1: 2817 REILLY ROAD
Address2: WOMACK ARMY MEDICAL CENTER MCXC COD CREDENTIALS
City: FORT BRAGG
State: NC
PostalCode: 28310
CountryCode: US
TelephoneNumber: 9109078922
FaxNumber: 9109076069
Other Information
ProviderEnumerationDate: 10/10/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
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AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207UN0901XMD5196HIN Allopathic & Osteopathic PhysiciansNuclear MedicineNuclear Cardiology
207UN0901X0101053168VAN Allopathic & Osteopathic PhysiciansNuclear MedicineNuclear Cardiology
207UN0901X NCY Allopathic & Osteopathic PhysiciansNuclear MedicineNuclear Cardiology

No ID Information.


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