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General NPI Number Information
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NPI Number | 1396869962
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Entity Type | Individual
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Provider Name | JOSEPH CHRISTOPHER CANVIN M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/19/2007
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Last Update Date | 05/14/2008
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Provider Practice Location Address
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Address Line | 320 HOSPITAL DR
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City | MARTINSVILLE
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State | VA
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Zip | 24112-1900
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Country | US
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Telephone | 301-991-0583
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 5186
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City | MARTINSVILLE
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State | VA
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Zip | 24115-5186
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Country | US
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Telephone | 301-991-0583
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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 | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 0101231456
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | D0057949
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License Number State | MD
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