Healthcare Provider Details

I. General information

NPI: 1588759583
Provider Name (Legal Business Name): FRANCIS CANNIZZO MBA, MD, PHD, FACS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 09/17/2021
Certification Date: 09/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

OFFICE OF THE CHIEF OF STAFF (11) 1970 ROANOKE BLVD.
SALEM VA
24018
US

IV. Provider business mailing address

OFFICE OF THE CHIEF OF STAFF (11) 1970 ROANOKE BLVD.
SALEM VA
24018
US

V. Phone/Fax

Practice location:
  • Phone: 540-982-2463
  • Fax: 540-983-1096
Mailing address:
  • Phone: 540-982-2463
  • Fax: 540-983-1096

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086X0206X
TaxonomySurgical Oncology Physician
License Number226625
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: