Provider Demographics
NPI:1497945232
Name:CARAVELLA, PETER ANTHONY (MD)
Entity Type:Individual
Prefix:DR
First Name:PETER
Middle Name:ANTHONY
Last Name:CARAVELLA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:9811 W CHARLESTON BLVD
Mailing Address - Street 2:SUITE#2640
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117-7528
Mailing Address - Country:US
Mailing Address - Phone:702-228-8834
Mailing Address - Fax:702-258-7787
Practice Address - Street 1:8930 W SUNSET RD
Practice Address - Street 2:SUITE#300
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89148-5008
Practice Address - Country:US
Practice Address - Phone:702-228-8834
Practice Address - Fax:702-258-7787
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-27
Last Update Date:2011-01-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL036115137208G00000X
NV10155208G00000X, 208600000X
CAA100758208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
No208600000XAllopathic & Osteopathic PhysiciansSurgery