Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 4351047036APP20 | MI |
NPI | 1013537638 |
---|---|
Provider Name | Dr. Daniel Ray Cavazos |
First Address | Carol Stream, IL 60188-2131 |
Second Address | Detroit, MI 48201-2153 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/04/2020 |
Last Update Date | 23/04/2020 |