Gregory M Cavanaugh in Greenfield - Physician Assistant
Gregory M Cavanaugh - NPI 1124084462
Gregory M Cavanaugh is a Physician Assistant in Greenfield, Wisconsin. Gregory M Cavanaugh practices all healthcare services and medical treatments related to Physician Assistant. The NPI Number for Gregory M Cavanaugh is 1124084462. The last update date is 2014-02-24.
Gregory M Cavanaugh's current location address is 4131 W. Loomis Rd., Greenfield, Wisconsin. You can contact this provider via phone number 4143257246 and fax number 4143253770. The mailing address for Gregory M Cavanaugh is 4131 W. Loomis Rd., Greenfield, Wisconsin. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Gregory M Cavanaugh |
|---|---|
| Address | 4131 W. Loomis Rd., Greenfield, Wisconsin |
| Phone Number | 4143257246 |
| Fax Number | 4143253770 |
| Sole Proprietor | N |
| Credentials | PA-C |
NPI Number Detail
| NPI Number | 1124084462 |
|---|---|
| Provider Enumeration Date | 2006-04-25 |
| Last Updated Date | 2014-02-24 |
Provider Mailing Address Detail
| Address | 4131 W. Loomis Rd. |
|---|---|
| City | Greenfield |
| State | Wisconsin (WI) |
| Post Code | 532212059 |
| Phone Number | 4143257246 |
| Fax Number | 4143253770 |
Provider's Primary Taxonomy Detail
| Speciality | Physician Assistant |
|---|---|
| Taxonomy | 363A00000X |
| Licence No | 1261023 |
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Definition: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perfor |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 30118100 | WI | -- |
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What is the unique identification code assigned to Gregory M Cavanaugh by the Centers for Medicare & Medicaid Services?
The Gregory M Cavanaugh has been issued the NPI (National Provider Identifier) 1124084462. This 10-digit code serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Where is the Gregory M Cavanaugh located?
The Gregory M Cavanaugh is located at 4131 W. Loomis Rd., Greenfield, WI 532212059.
What is Gregory M Cavanaugh's specialized field of practice, and what is the corresponding taxonomy classification code?
The Gregory M Cavanaugh's area of specialization is Physician Assistant, and the corresponding taxonomy code that categorizes this field of practice is 363A00000X.
On what date did the Centers for Medicare & Medicaid Services issue the 1124084462 to Gregory M Cavanaugh?
The Gregory M Cavanaugh received its 1124084462 assignment from the Centers for Medicare & Medicaid Services on 2006-04-25.
As of what date was the information regarding Gregory M Cavanaugh, such as address, specialty, and other details, last verified and confirmed to be up-to-date?
The information related to Gregory M Cavanaugh, including its address, specialty, and other relevant details, was last verified and confirmed to be up-to-date on 2014-02-24.