Provider Demographics
NPI:1053907949
Name:CARVALHO, GEORGE FELLIPE (NP)
Entity type:Individual
Prefix:
First Name:GEORGE
Middle Name:FELLIPE
Last Name:CARVALHO
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:735 ATTUCKS LN
Mailing Address - Street 2:
Mailing Address - City:HYANNIS
Mailing Address - State:MA
Mailing Address - Zip Code:02601-1867
Mailing Address - Country:US
Mailing Address - Phone:508-778-0300
Mailing Address - Fax:
Practice Address - Street 1:735 ATTUCKS LN
Practice Address - Street 2:
Practice Address - City:HYANNIS
Practice Address - State:MA
Practice Address - Zip Code:02601-1867
Practice Address - Country:US
Practice Address - Phone:508-778-0300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-15
Last Update Date:2020-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2309202363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily