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Individual

RICHARD E CARBALLO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2801 W KK RIVER PKWY, SUITE 330, MILWAUKEE, WI 53215-3669
(414) 649-3240
(414) 649-3244
Mailing address
2801 W KK RIVER PKWY, SUITE 330, MILWAUKEE, WI 53215-3669
(414) 649-3240
(414) 649-3244

Taxonomy

Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
34732
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
32104600
WI
Enumeration date
03/10/2006
Last updated
12/21/2021
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