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MR. BRUCE ALAN CAVANAUGH PA-C

Medical >> Physician Assistant >> Physician Assistants & Advanced Practice Nursing Providers

Registrant NPI Number: 1689633414

Individual Registrant:
MR. BRUCE ALAN CAVANAUGH PA-C
Gender: M
Not Sole Proprietor

Location and contact information for practice:
9987 VILLAGE GREEN DR  WOODSTOCK, MD 21163-1155 US
Tel: 443-570-2782  Fax: 443-570-2782

Contact information for business:
9987 VILLAGE GREEN DR  WOODSTOCK, MD 21163-1155 US
Tel: 443-570-2782  Fax: 443-570-2782

Registration Information:
NPI: 1689633414
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y363AM0700XPhysician Assistants & Advanced Practice Nursing Providers
Physician Assistant
Medical
MDC002022
N363A00000XPhysician Assistants & Advanced Practice Nursing Providers
Physician Assistant
MDC002022

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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