Individual
MICHAEL R. CANADY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
100 JACKSON PIKE, GALLIPOLIS, OH 45631-1560
(740) 446-5225
(740) 446-5532
Mailing address
90 JACKSON PIKE, GALLIPOLIS, OH 45631-1560
(740) 441-1934
(740) 446-5956
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
18473
WV
208600000X
Surgery Physician
Primary
35-06-0982
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000007322
ANTHEM BCBS
—
01
—
000000181583
UNISON MEDICAID
OH
01
—
001714083
MOUNTAIN STATE BCBS
—
05
—
0126280000
—
WV
01
—
0154256
OHIO MEDICAID MOLINA
OH
01
—
020027086
RR MEDICARE
—
01
—
310917085091
CARESOURCE MEDICAID
OH
Enumeration date
05/17/2006
Last updated
11/05/2019
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