Individual
MICHAEL COYNE KAVANAUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
593 EDDY ST, PROVIDENCE, RI 02903
(401) 444-4000
Mailing address
125 METRO CENTER BLVD STE 2000, WARWICK, RI 02886-1785
(401) 432-2500
(401) 889-3619
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
1013402
MA
2085R0202X
Diagnostic Radiology Physician
Primary
MD17199
RI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/24/2017
Last updated
04/05/2024
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