Individual
JOHN CAVACECE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
300 LAFAYETTE AVE SE, SUITE 4200, GRAND RAPIDS, MI 49503-4650
(616) 685-6922
(616) 685-5105
Mailing address
245 STATE ST SE, GRAND RAPIDS, MI 49503-4328
(616) 685-1808
(616) 685-1850
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
5101013293
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3290666
—
MI
05
—
3364634
—
MI
05
—
3415564
—
MI
05
—
3495251
—
MI
05
—
4597031
—
MI
05
—
4878391
—
MI
Enumeration date
05/18/2006
Last updated
06/26/2009
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