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Individual

JOEL B KAVANAGH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
17254
MS
174400000X
Specialist
207R00000X
Internal Medicine Physician
Primary
17254
MS
208M00000X
Hospitalist Physician
17254
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0124651
MS
05
03551501
MS
01
7927259
AETNA
MS
01
MEDICARE RR
110222271
MS
Enumeration date
08/31/2006
Last updated
11/09/2022
Update your record

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