Healthcare Provider Details

I. General information

NPI: 1952494791
Provider Name (Legal Business Name): C A CAHALL M D, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

205 W 6TH ST
EAST LIVERPOOL OH
43920-2801
US

IV. Provider business mailing address

205 W 6TH ST
EAST LIVERPOOL OH
43920-2801
US

V. Phone/Fax

Practice location:
  • Phone: 330-385-9509
  • Fax: 330-385-1008
Mailing address:
  • Phone: 330-385-9509
  • Fax: 330-385-1008

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number35081145
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN215713
License Number StateOH

VIII. Authorized Official

Name: DR. CLEMENT A CAHALL
Title or Position: PRESIDENT
Credential: M.D.
Phone: 330-385-9509