Individual
JAMES WILLIAM CANAVAN
Active
Individual
JAMES WILLIAM CANAVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
126376
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00010025104
UNIVERA
NY
01
—
000500325008
BC/BS
NY
05
—
00602828
—
NY
01
—
040426001488
FIDELIS
NY
01
—
1208948
IHA
NY
01
—
146916DL
PREFERRED CARE
NY
Enumeration date
09/23/2005
Last updated
09/02/2011
Update your record
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