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Individual

DR. ALLAN D CAUDILL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
940 BLUE STAR HWY, SOUTH HAVEN, MI 49090-7758
(269) 639-2893
Mailing address
955 S BAILEY AVE, SOUTH HAVEN, MI 49090-6743
(269) 639-2874

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
0101235364
VA
208600000X
Surgery Physician
Primary
4301050127
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
010011795
VA
Enumeration date
12/06/2005
Last updated
02/23/2023
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