Individual
DR. MATHEW M CANNAVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
247 N FIREWEED ST, STE B, SOLDOTNA, AK 99669-7540
(907) 262-7546
(907) 262-7599
Mailing address
PO BOX 780, SOLDOTNA, AK 99669-0780
(907) 262-7546
(907) 262-7599
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
AK4179
AK
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
AK4179
AK
207ND0900X
Dermatopathology Physician
AK4179
AK
207NI0002X
Clinical & Laboratory Dermatological Immunology Physician
AK4179
AK
207NP0225X
Pediatric Dermatology Physician
AK4179
AK
207NS0135X
Procedural Dermatology Physician
AK4179
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
MD16711
—
AK
Enumeration date
02/28/2007
Last updated
02/10/2009
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