DR. MARY L CANNON (NPI# 1679532592) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679532592 |
| Entity Type | Individual |
| Full Name | DR. MARY L CANNON |
| Credential | M.D. |
| Practice Address |
101 Stadium Dr Morgantown WV 26506-7911 |
| Mailing Address |
Po Box 897 Morgantown WV 26507-0897 |
| Practice Telephone | 3045984000 |
| Practice Fax Number | 3042936963 |
| Mailing Telephone | 3042937401 |
| Mailing Fax Number | 3042936963 |
| Enumeration Date | 2006-03-20 |
| Last Update Date | 2020-10-17 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
20506 | WV | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WV | 1807576000 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700343530 | Mary Elizabeth Cannon | Counselor | 1711 E Central Texas Expy # 30, Killeen, TX 76541-9166 | 2019-02-28 |
| 1508217209 | Mary Cannon | Registered Nurse | 29686 Millstream Dr, Salisbury, MD 21804-2002 | 2016-06-24 |
| 1164593661 | Mary Elizabeth Cannon | Counselor | 69 Surfside Ave, Montauk, NY 11954-0896 | 2006-11-13 |
| 1144789694 | Mary Cannon | Nurse Practitioner | 5950 University Ave Ste 341, West Des Moines, IA 50266-8289 | 2019-03-14 |
| 1053600825 | Mary Sprowl Cannon | Marriage & Family Therapist | 1101 S Winchester Blvd, Suite A101, San Jose, CA 95128-3901 | 2011-04-01 |
| 1477883668 | Mary Dale Cannon | Psychologist | 2775 Executive Park Nw, Suite 1, Cleveland, TN 37312-2763 | 2010-01-11 |
| 1871711101 | Mary P Cannon | Social Worker | 1190 N 900 E, Provo, UT 84604-3536 | 2007-04-23 |
| 1801930623 | Mary Cannon | Registered Nurse | 31 Hosier St, Selbyville, DE 19975-9300 | 2007-02-16 |
| 1023127891 | Mary J Cannon | Obstetrics & Gynecology | 545 Plainfield Rd, Suite C, Willowbrook, IL 60527-7600 | 2006-08-29 |
| Street Address |
101 STADIUM DR |
| City | MORGANTOWN |
| State | WV |
| Zip Code | 26506-7911 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396721817 | Daniel Allen Martin | Radiology | 101 Stadium Dr, Morgantown, WV 26506-7911 | 2005-12-16 |
| 1023646023 | Shreyas Shirodkar | Student in an Organized Health Care Education/Training Program | 101 Stadium Dr, Morgantown, WV 26506-7911 | 2020-03-27 |
| 1972130946 | Bandar Ali Alyami | Student in an Organized Health Care Education/Training Program | 101 Stadium Dr, Morgantown, WV 26506-7911 | 2020-03-26 |
| 1568099513 | Jacob Wayne Helsel Jr. | Student in an Organized Health Care Education/Training Program | 101 Stadium Dr, Morgantown, WV 26506-7911 | 2020-03-26 |
| 1063049112 | Sher Ahmed Khan | Student in an Organized Health Care Education/Training Program | 101 Stadium Dr, Morgantown, WV 26506-7911 | 2020-03-26 |
| 1932736360 | Christopher Jeffery Gates | Student in an Organized Health Care Education/Training Program | 101 Stadium Dr, Morgantown, WV 26506-7911 | 2020-03-25 |
| 1316574726 | Braden Ellis Taylor | Student in an Organized Health Care Education/Training Program | 101 Stadium Dr, Morgantown, WV 26506-7911 | 2020-03-25 |
| 1659908945 | Gregory Adam Perkowski | Student in an Organized Health Care Education/Training Program | 101 Stadium Dr, Morgantown, WV 26506-7911 | 2020-03-25 |
| 1043847841 | Katherine Louise Bergman | Student in an Organized Health Care Education/Training Program | 101 Stadium Dr, Morgantown, WV 26506-7911 | 2020-03-24 |
| 1942837570 | Aisha Abbasi | Student in an Organized Health Care Education/Training Program | 101 Stadium Dr, Morgantown, WV 26506-7911 | 2020-03-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124656491 | Lauren Bakos | Student in an Organized Health Care Education/Training Program | Department of Oral Surgery Room 1200 Hsc North, Morgantown, WV 26506 | 2020-03-31 |
| 1720613888 | Katharina Marie Mitchell | Student in an Organized Health Care Education/Training Program | Wvu Hospitals Ruby Memorial & Physician Office Center, 1 Medical Center Drive, Morgantown, WV 26506 | 2020-03-10 |
| 1811533961 | Hongyan Wu | Nurse Practitioner | Neurology Clinic, Wvu Eye Institute, 1 Medical Center Drive, Morgantown, WV 26506 | 2019-11-25 |
| 1871054569 | Brandon Chase Neeley | Student in an Organized Health Care Education/Training Program | 1 Stadium Dr Fl 3 Eye Institute, Morgantown, WV 26506 | 2019-03-26 |
| 1588125223 | Temitope Michael Kehinde | Student in an Organized Health Care Education/Training Program | 64 Medical Center Drive 2305hscn, Morgantown, WV 26506 | 2019-03-26 |
| 1417412743 | West Virginia University Hospitals, Inc. | Substance Abuse Rehabilitation Facility | 751 Benefactor Drive, Morgantown, WV 26506 | 2019-01-31 |
| 1932603024 | Emma Bacharach | Student in an Organized Health Care Education/Training Program | J.w. Ruby Memorial Hospital, 1 Medical Center Drive, Morgantown, WV 26506 | 2018-03-22 |
| 1982108270 | Qaisar Syed | Student in an Organized Health Care Education/Training Program | Wvu Medicine Anesthesiology, 1 Medical Center Drive, Morgantown, WV 26506 | 2018-03-21 |
| 1417451063 | Michael Savilla | Student in an Organized Health Care Education/Training Program | Wvu Medicine Anesthesiology, 1 Medical Center Drive, Morgantown, WV 26506 | 2018-03-20 |
| 1194255620 | William Black | Dentist | Room 1200 Hsc North, P.o. Box 9475, Morgantown, WV 26506 | 2017-06-18 |
| Find all providers in zip 26506 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942612197 | Health and Education Building-urgent Care | Radiology | 390 Birch Street Suite B, Morgantown, WV 26506-6894 | 2014-05-22 |
| 1467795591 | Philip Connor Louden | Radiology | 1 Medical Center Dr, Room 1144, Morgantown, WV 26506 | 2013-03-27 |
| 1871818872 | Cara M Bryan | Radiology | 1 Medical Center Drive 9001a, Morgantown, WV 26506 | 2010-04-01 |
| 1407815772 | Teppe Popovich | Radiology | 364 Patteson Drive, Morgantown, WV 26505 | 2006-03-23 |
| 1396721817 | Daniel Allen Martin | Radiology | 101 Stadium Dr, Morgantown, WV 26506-7911 | 2005-12-16 |
| 1245230549 | William L Noble | Radiology | 99 J D Anderson Dr, Morgantown, WV 26505-4000 | 2005-07-28 |
| 1487064689 | Ariel Bailey | Radiology | 1 Medical Center Drive, Room 1144, Morgantown, WV 26506 | 2014-04-28 |
| 1063760429 | Brian Markovich | Radiology | 1 Medical Center Dr, Morgantown, WV 26506-1200 | 2012-08-16 |
| 1437416302 | Parissa Feizi | Radiology | 1 Medical Center Dr, Morgantown, WV 26506-1200 | 2012-04-17 |
| 1376819755 | Mark Forrest Lisle | Radiology | 1 Medical Center Drive, Room 1144, Morgantown, WV 26506 | 2012-03-29 |
| Find all providers in MORGANTOWN | ||||
| City | MORGANTOWN |
| Zip Code | 26506 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.