Individual
MAURICIO DANIEL CARBALLO MONTERO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
10863 MARIAM LN, DAYTON, OH 45458-6412
(937) 545-1539
Mailing address
10863 MARIAM LN, DAYTON, OH 45458-6412
(937) 545-1539
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
35.138586
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0396368
—
OH
Enumeration date
09/10/2010
Last updated
03/05/2026
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