Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | 045741 | GA |
NPI | 1093771586 |
---|---|
Provider Name | C Michael Cawley III |
First Address | Atlanta, GA 30322 |
Second Address | Atlanta, GA 30322 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/04/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A15350 | (02) |