Individual
DR. JOHN J CAVANAUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
211 N EDDY ST, SOUTH BEND, IN 46617-2808
(574) 237-9331
(574) 237-9252
Mailing address
211 N EDDY ST, SOUTH BEND, IN 46617-2808
(574) 237-9331
(574) 237-9252
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
01035159A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100090160
—
IN
Enumeration date
10/17/2005
Last updated
06/23/2015
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