Organization
DR. DAVID C. CAVALLARO, D.P.M., INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID CARL CAVALLARO DPM (CEO)
(405) 631-2333
Entity
Organization
Contact information
Practice address
7370 S WALKER AVE, OKLAHOMA CITY, OK 73139-7628
(405) 631-2333
(405) 631-2350
Mailing address
7370 S WALKER AVE, OKLAHOMA CITY, OK 73139-7628
(405) 631-2333
(405) 631-2350
Taxonomy
Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
140
OK
213ES0103X
Foot & Ankle Surgery Podiatrist
140
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
078425699002
BCBS PROVIDER #
OK
05
—
100779410A
—
OK
01
—
1548261050
INDIVIDUAL NPI #
OK
Enumeration date
03/15/2007
Last updated
10/25/2011
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