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Individual

DR. JOHN FREDERICK REAVEY-CANTWELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1250 E MARSHALL ST, NEUROSURGERY, RICHMOND, VA 23298-5051
(804) 828-9165
(804) 828-0374
Mailing address
PO BOX 91734, RICHMOND, VA 23291-1734
(804) 358-6100
(804) 342-7619

Taxonomy

Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
0101242977
VA
207T00000X
Neurological Surgery Physician
ME92657
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
280197300
FL
Enumeration date
10/23/2006
Last updated
07/30/2008
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