Provider Demographics
NPI:1003992918
Name:CARVETH, WILLIAM L (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:L
Last Name:CARVETH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6121 N THESTA
Mailing Address - Street 2:SUITE 202
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93710
Mailing Address - Country:US
Mailing Address - Phone:559-440-0283
Mailing Address - Fax:559-440-0192
Practice Address - Street 1:6121 N THESTA
Practice Address - Street 2:SUITE 202
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93710
Practice Address - Country:US
Practice Address - Phone:559-440-0283
Practice Address - Fax:559-440-0192
Is Sole Proprietor?:No
Enumeration Date:2006-10-31
Last Update Date:2008-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG51200208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G512000Medicaid
F07964Medicare UPIN
CA00G512000Medicare ID - Type Unspecified