Individual
MICHAEL T CANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD, PHD
Contact information
Practice address
4721 READING ROAD, CINCINNATI, OH 45237
(513) 242-3539
Mailing address
819 OAK CANYON DRIVE, LOVELAND, OH 45140
(513) 774-7239
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
35093566
OH
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
35093566
OH
Other
Enumeration date
05/25/2007
Last updated
09/26/2013
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