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General NPI Number Information
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NPI Number | 1588640445
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Entity Type | Individual
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Provider Name | DOUGLAS EDWARD CANHAM MD
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Gender | Male
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Dates
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Enumeration Date | 12/21/2005
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 18653 WEDGE PKWY
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City | RENO
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State | NV
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Zip | 89511-3005
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Country | US
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Telephone | 775-770-7210
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Fax |
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Provider Business Mailing Address
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Address Line | 2610 STRATHMORE CT
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City | RENO
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State | NV
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Zip | 89521-6231
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Country | US
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Telephone | 775-851-1056
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Fax | 775-851-7680
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 11356
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 17440
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License Number State | CO
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