Healthcare Provider Details

I. General information

NPI: 1285743393
Provider Name (Legal Business Name): PAULA L CAHILL M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 09/26/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 MUNSON AVE, SUITE 200
TRAVERSE CITY MI
49686
US

IV. Provider business mailing address

550 MUNSON AVE, SUITE 200
TRAVERSE CITY MI
49686
US

V. Phone/Fax

Practice location:
  • Phone: 231-935-8717
  • Fax: 231-935-9230
Mailing address:
  • Phone: 231-935-8717
  • Fax: 231-935-9230

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number4301063462
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: