Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 35.128745 | OH |
NPI | 1003109927 |
---|---|
Provider Name | Matthew John Cavo |
First Address | Centerville, OH 45459-4778 |
Second Address | Centerville, OH 45459-4778 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/05/2011 |
Last Update Date | 20/04/2017 |