DoctorDataHub
Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

DR. CARLOS JAVIER GLANVILLE MIRANDA, M.D.

Active Sole Proprietor

Colon & Rectal Surgery · SUFFOLK, VA

Registration Details

NPI Number
1275705253
Provider Type
Individual
Gender
Male
NPI Issued
Mar 30, 2008 (18.060184038928 yrs)
Last Updated
Feb 17, 2022
Licenses
0101252033 (VA)
MT188562 (PA)
0101252033 (VA)
Sole Proprietor
Yes

Practice Information

Address
2790 GODWIN BLVD STE 305
SUFFOLK, VA, 234348158
Browse VA providers · Browse ZIP 23434
Phone
7579314222
Fax
7579344111
Primary Specialty
Colon & Rectal Surgery
208C00000X
Additional Specialty
General Surgery
Additional Specialty
Colon & Rectal Surgery

Other Colon & Rectal Surgery Providers in SUFFOLK, VA

Name Credential NPI
RAY THOMAS RAMIREZ M.D. 1912960352
DR. JOSEPH LAWRENCE FRENKEL M.D. 1679765804
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.