Individual
DR. MICHAEL PATRICK GANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
730 N BROAD ST STE 200A, WOODBURY, NJ 08096-1796
(856) 251-2340
Mailing address
301 LIPPINCOTT DR STE 410, MARLTON, NJ 08053-4197
(856) 355-0340
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
251885
MA
207RC0000X
Cardiovascular Disease Physician
Primary
25MA12053900
NJ
207RC0000X
Cardiovascular Disease Physician
MD466806
PA
Other
Enumeration date
06/06/2012
Last updated
08/28/2024
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