Healthcare Provider Details

I. General information

NPI: 1295735538
Provider Name (Legal Business Name): MICHAEL DAVID CAWDERY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2005
Last Update Date: 03/11/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

155 N FRESNO ST UCSF-FRESNO DEPT OF EMERGENCY MEDICINE
FRESNO CA
93701-2302
US

IV. Provider business mailing address

155 N FRESNO ST UCSF-FRESNO DEPT OF EMERGENCY MEDICINE
FRESNO CA
93701-2302
US

V. Phone/Fax

Practice location:
  • Phone: 559-499-6440
  • Fax: 559-499-6441
Mailing address:
  • Phone: 559-499-6440
  • Fax: 559-499-6441

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberA77280
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: