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NPI 1194726950

NPI 1194726950 : RAYMOND A. CAVA MD : FORT WAYNE, IN

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General NPI Number Information
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    NPI Number           |    1194726950
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    Entity Type          |    Individual 
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    Provider Name        |    RAYMOND A. CAVA MD
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    08/02/2005
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    Last Update Date     |    10/17/2022
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Provider Practice Location Address
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    Address Line         |    11141 PARKVIEW PLAZA DR STE 305 
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    City                 |    FORT WAYNE
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    State                |    IN
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    Zip                  |    46845-1715
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    Country              |    US
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    Telephone            |    260-484-9611
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    Fax                  |    260-484-1004
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Provider Business Mailing Address
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    Address Line         |    11109 PARKVIEW PLAZA DR # 117 
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    City                 |    FORT WAYNE
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    State                |    IN
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    Zip                  |    46845-1701
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    Country              |    US
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    Telephone            |    
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    208600000X
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    Taxonomy Name        |    Surgery Physician
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    License Number       |    01057472A
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    License Number State |    IN
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Taxonomy #2
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    Taxonomy Code        |    2086S0127X
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    Taxonomy Name        |    Trauma Surgery Physician
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    License Number       |    01057472A
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    License Number State |    IN
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