Healthcare Provider Details
I. General information
NPI: 1528019015
Provider Name (Legal Business Name): JOSEPH R CAVA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 05/12/2006
Last Update Date: 03/11/2024
Certification Date: 03/11/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
9000 W WISCONSIN AVE PEDIATRIC CARDIOLOGY
MILWAUKEE WI
53226-4874
US
IV. Provider business mailing address
9000 W WISCONSIN AVE PEDIATRIC CARDIOLOGY
MILWAUKEE WI
53226-4874
US
V. Phone/Fax
- Phone: 414-266-6457
- Fax: 414-266-2294
- Phone: 414-266-6457
- Fax: 414-266-2294
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2080P0202X |
| Taxonomy | Pediatric Cardiology Physician |
| License Number | 36899 |
| License Number State | WI |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: