Individual
MICHAEL L CANTWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
515 BAYOU ST., VINCENNES, IN 47591-1034
(812) 886-6800
(812) 886-6809
Mailing address
515 BAYOU ST., VINCENNES, IN 47591-1034
(812) 886-6800
(812) 886-6809
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
01038101A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000110674
ANTHEM
IN
05
—
200023120
—
IN
Enumeration date
07/28/2005
Last updated
07/21/2022
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