Individual
DR. MICHAEL KEVIN GANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2979 SQUALICUM PKWY, SUITE #203, BELLINGHAM, WA 98225-1811
(360) 733-7670
(360) 647-1901
Mailing address
2979 SQUALICUM PKWY, SUITE #203, BELLINGHAM, WA 98225-1811
(360) 733-7670
(360) 647-1901
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
MD00021195
WA
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
MD00021195
WA
Other
Enumeration date
07/19/2006
Last updated
02/01/2021
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