Individual
MICHAEL CACCAMO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
540 LINCOLN PARK BLVD, STE 130, KETTERING, OH 45429-6401
(937) 297-6306
(937) 299-6300
Mailing address
540 LINCOLN PARK BLVD, STE 130, KETTERING, OH 45429-6401
(937) 297-6306
(937) 299-6300
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
34-00-6134C
OH
2085R0202X
Diagnostic Radiology Physician
5101010916
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0145033
—
OH
Enumeration date
08/16/2005
Last updated
12/01/2014
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