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Individual

MICHAEL T CANAVAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
789 PINEY FOREST RD, SUITE B, DANVILLE, VA 24540-2877
(434) 799-9430
(434) 792-8438
Mailing address
789 PINEY FOREST RD, SUITE B, DANVILLE, VA 24540-2877
(434) 799-9430
(434) 792-8438

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
0103 000583
VA
213E00000X
Podiatrist
219
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
009301631
VA
01
017094
ANTHEM
VA
01
890803N
BCBS OF NORTH CAROLINA
NC
Enumeration date
06/16/2006
Last updated
03/29/2013
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