1447338413 NPI number — DR. MARIA CAVALIERE M.D.

Table of content: DR. MARIA CAVALIERE M.D. (NPI 1447338413)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1447338413 NPI number — DR. MARIA CAVALIERE M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CAVALIERE
Provider First Name:
MARIA
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1447338413
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/17/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
682 HEMLOCK ST
Provider Second Line Business Mailing Address:
SUITE 200
Provider Business Mailing Address City Name:
MACON
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
31201-6883
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
478-746-0901
Provider Business Mailing Address Fax Number:
478-330-6150

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
682 HEMLOCK ST
Provider Second Line Business Practice Location Address:
SUITE 200
Provider Business Practice Location Address City Name:
MACON
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
31201-6883
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
478-746-0901
Provider Business Practice Location Address Fax Number:
478-330-6150
Provider Enumeration Date:
11/01/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  055662 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1689826315 . This is a "GROUP NPI" identifier , issued by the state of ( GA ) . This identifiers is of the category "OTHER".
  • Identifier: P00706992 . This is a "RAILROAD MEDICARE PTAN" identifier , issued by the state of ( GA ) . This identifiers is of the category "OTHER".
  • Identifier: DO7908 . This is a "RAILROAD MCARE GRP #" identifier , issued by the state of ( GA ) . This identifiers is of the category "OTHER".
  • Identifier: 594949079E , issued by the state of ( GA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1447338413 . This is a "IND NPI" identifier , issued by the state of ( GA ) . This identifiers is of the category "OTHER".
  • Identifier: 594949079A , issued by the state of ( GA ) . This identifiers is of the category "MEDICAID".




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