Individual
DAVID CANNON
Active
Individual
DAVID CANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101033109
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110001969
MEDICARE RAILROAD CARRIER
VA
01
—
198909
ANTHEM
—
05
—
6097898
—
VA
Enumeration date
11/29/2005
Last updated
01/21/2014
Update your record
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