MR. BRUCE ALAN CAVANAUGH (NPI# 1689633414) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1689633414 |
Entity Type | Individual |
Full Name | MR. BRUCE ALAN CAVANAUGH |
Credential | PA-C |
Practice Address |
9987 Village Green Dr Woodstock MD 21163-1155 |
Practice Telephone | 4435702782 |
Practice Fax Number | 4435702782 |
Mailing Telephone | 4435702782 |
Mailing Fax Number | 4435702782 |
Enumeration Date | 2006-03-21 |
Last Update Date | 2016-04-13 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 363A00000X | Physician Assistant | C002022 | MD | Physician Assistants & Advanced Practice Nursing Providers |
Y | 363AM0700X |
Physician Assistant Specialization: Medical |
C002022 | MD | Physician Assistants & Advanced Practice Nursing Providers |
Street Address |
9987 VILLAGE GREEN DR |
City | WOODSTOCK |
State | MD |
Zip Code | 21163-1155 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1831680958 | Bestcare Home Inc | In Home Supportive Care | 10617 Duthess Way, Woodstock, MD 21163 | 2018-05-24 |
1073973897 | Stephanie P. Bathurst | Marriage & Family Therapist | 21 Deep Powder Court, Woodstock, MD 21163 | 2016-03-07 |
1508201153 | American Advanced Nursing and Rehab | Physical Therapist | 10708 Croydon Ct, Woodstock, MD 21163 | 2013-05-08 |
1578856928 | Faithe Maria Braznell | Pharmacist | 3319 Peddicoat Court, Woodstock, MD 21163 | 2011-05-18 |
1497070452 | William Henry Gregory Jr. | Counselor | 9985 Village Green Drive, Woodstock, MD 21163 | 2010-04-02 |
1225014459 | Stephan A Bart Sr. | Family Medicine | 10403 Wetherburn Rd, Woodstock, MD 21163 | 2005-12-20 |
1184138737 | Best Healthcare Agency, Inc | Home Health | 3507 Timber Crest Ln, Woodstock, MD 21163-1055 | 2017-11-18 |
1811526742 | Domonique Parkes | Student in an Organized Health Care Education/Training Program | 17 Deep Powder Ct, Woodstock, MD 21163-1110 | 2020-04-03 |
1477816445 | Aroon Suansilppongse | Psychiatry & Neurology | 1 Deep Powder Ct, Woodstock, MD 21163-1110 | 2012-06-24 |
1154513638 | Foot Savers Inc. | Nurse Practitioner | 2815 Granite Rd, Woodstock, MD 21163-1127 | 2007-08-17 |
Find all providers in zip 21163 |
Taxonomy Code | 363AM0700X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Physician Assistant |
Specialization | Medical |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1841379476 | Jamie Gillis | Physician Assistant | 900 Towe Lake Parkway, Suite 400, Woodstock, GA 30189 | 2006-11-03 |
1699171223 | Julie Lynn Banks | Physician Assistant | 250 Parkbrooke Pl, Suite 300, Woodstock, GA 30189-6400 | 2014-11-10 |
1972915395 | Woodstock Family Practice and Urgent Care | Physician Assistant | 310 Gold Creek Trl, Woodstock, GA 30188-5435 | 2014-05-21 |
1669883971 | Jenna M Raju | Physician Assistant | 2000 Lake Ave, Woodstock, IL 60098-7401 | 2014-05-09 |
1205002151 | Nicole T Rivera | Physician Assistant | 900 Towne Lake Pkwy, Suite 308, Woodstock, GA 30189-1602 | 2008-05-01 |
1154591543 | Angela M Emmons | Physician Assistant | 759 S Main St, Suite 300, Woodstock, VA 22664-1127 | 2008-03-03 |
1275756207 | Patrick M. Fleming | Physician Assistant | 203 Woodpark Pl, Bldg. C, Woodstock, GA 30188-3705 | 2007-04-10 |
1922133768 | Georgia Urgent Care, - Alpharetta, LLC | Physician Assistant | 7820 Hickory Flat Hwy, Woodstock, GA 30188-2099 | 2007-02-22 |
1316003577 | Tomas J Chao | Physician Assistant | 100 Stoneforest Dr, Suite 320, Woodstock, GA 30189-4880 | 2006-12-29 |
1265534895 | Eugene Dougherty | Physician Assistant | 404 Zena Rd, Woodstock, NY 12498-2626 | 2006-09-03 |
Find all providers in WOODSTOCK |
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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.