Provider Demographics
NPI:1457434870
Name:CARVALHO, CLETUS SAVIO (MD)
Entity Type:Individual
Prefix:DR
First Name:CLETUS
Middle Name:SAVIO
Last Name:CARVALHO
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 1:3070 LAKECREST CIR # 400-197
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40513-1937
Mailing Address - Country:US
Mailing Address - Phone:859-263-3888
Mailing Address - Fax:888-235-9895
Practice Address - Street 1:3070 LAKECREST CIR # 400-197
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40513-1937
Practice Address - Country:US
Practice Address - Phone:859-263-3888
Practice Address - Fax:888-235-9895
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-21
Last Update Date:2019-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY351672084P0805X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64059330Medicaid
KY64059330Medicaid
G98480Medicare UPIN