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Individual

DR. MARK DAVID CANNING

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
55 FOGG RD, SOUTH WEYMOUTH, MA 02190-2432
(781) 340-8000
Mailing address
163 LIBBEY PKWY, SUITE 301, WEYMOUTH, MA 02189-3101
(781) 337-4224
(781) 335-0429

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
15177
MA
207LP2900X
Pain Medicine (Anesthesiology) Physician
15177
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
273479
HARVARD PILGRIM
MA
01
3168123
HEALTHY START
MA
05
3168123
MA
01
37767
FALLON
MA
01
767488
TUFTS
MA
01
J17824
BLUE SHIELD
MA
Enumeration date
04/10/2006
Last updated
05/02/2008
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