Individual
MIGUEL G CARBONELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3190 STATE ST, 102, MEDFORD, OR 97504
(541) 773-1565
(541) 773-1929
Mailing address
3190 STATE ST, 102, MEDFORD, OR 97504-8498
(541) 773-1565
(541) 773-1929
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
MD19893
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
081815
—
OR
Enumeration date
12/01/2006
Last updated
01/02/2008
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