Individual
RALPH F CARBONE JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
212 W EDISON RD STE F, MISHAWAKA, IN 46545-8301
(574) 257-0621
(574) 257-0641
Mailing address
212 W EDISON RD, SUITE F, MISHAWAKA, IN 46545-8301
(574) 257-0621
(574) 257-0641
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
02001120A
IN
208VP0014X
Interventional Pain Medicine Physician
Primary
02001120
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200540580
—
IN
Enumeration date
04/06/2006
Last updated
07/21/2022
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