Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223S0112X | Oral and Maxillofacial Surgeon | GI-0000944 | DE |
NPI | 1043202039 |
---|---|
Provider Name | Michael L Cahoon |
First Address | Lewes, DE 19958-1772 |
Second Address | Lewes, DE 19958-1772 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/08/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0000911802 | (05) | DE |
T84938 | (02) |