Provider Demographics
NPI:1073936274
Name:GALVAO-SOBRINHO, CARLOS R (MD, PHD)
Entity Type:Individual
Prefix:
First Name:CARLOS
Middle Name:R
Last Name:GALVAO-SOBRINHO
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3805B SPRING ST STE 260
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:WI
Mailing Address - Zip Code:53405-1643
Mailing Address - Country:US
Mailing Address - Phone:262-687-8340
Mailing Address - Fax:262-687-8365
Practice Address - Street 1:3805B SPRING ST STE 260
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:WI
Practice Address - Zip Code:53405-1643
Practice Address - Country:US
Practice Address - Phone:262-687-8340
Practice Address - Fax:262-687-8365
Is Sole Proprietor?:No
Enumeration Date:2014-01-24
Last Update Date:2018-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT52461207R00000X, 207RN0300X
WI61922207R00000X, 207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine