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General NPI Number Information
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NPI Number | 1457434870
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Entity Type | Individual
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Provider Name | CLETUS SAVIO CARVALHO MD
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Gender | Male
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Dates
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Enumeration Date | 10/21/2006
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Last Update Date | 06/14/2019
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Provider Practice Location Address
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Address Line | 3070 LAKECREST CIR # 400-197
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City | LEXINGTON
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State | KY
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Zip | 40513-1937
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Country | US
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Telephone | 859-263-3888
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Fax | 888-235-9895
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Provider Business Mailing Address
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Address Line | 3070 LAKECREST CIR # 400-197
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City | LEXINGTON
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State | KY
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Zip | 40513-1937
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Country | US
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Telephone | 859-263-3888
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Fax | 888-235-9895
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0805X
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Taxonomy Name | Geriatric Psychiatry Physician
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License Number | 35167
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 35167
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License Number State | KY
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