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General NPI Number Information
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NPI Number | 1588693683
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Entity Type | Organization
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Legal Business Name | WISSAHICKON ORTHOPAEDIC SPECIALISTS P.C.
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Dates
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Enumeration Date | 07/01/2006
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Last Update Date | 12/13/2021
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Provider Practice Location Address
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Address Line | 1401 BETHLEHEM PIKE
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City | FLOURTOWN
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State | PA
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Zip | 19031
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Country | US
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Telephone | 215-233-1001
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Fax | 215-233-9749
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Provider Business Mailing Address
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Address Line | 1401 BETHLEHEM PIKE
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City | FLOURTOWN
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State | PA
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Zip | 19031
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Country | US
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Telephone | 215-233-1001
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Fax | 215-233-9749
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Authorized Official
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Title or Position | PRACTICE OWNER
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Name | MICHAEL FRANCIS CAVANAUGH
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Credential | M.D.
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Telephone | 215-233-1001
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | MD013366E
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License Number State | PA
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