Individual
DR. CARLOS JAVIER GLANVILLE MIRANDA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2790 GODWIN BLVD STE 305, SUFFOLK, VA 23434-8158
(757) 931-4222
(757) 934-4111
Mailing address
2790 GODWIN BLVD STE 305, SUFFOLK, VA 23434-8158
(757) 931-4222
(757) 934-4111
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
0101252033
VA
208600000X
Surgery Physician
MT188562
PA
208C00000X
Colon & Rectal Surgery Physician
Primary
0101252033
VA
Other
Enumeration date
03/30/2008
Last updated
02/17/2022
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