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General NPI Number Information
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NPI Number | 1619914322
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Entity Type | Individual
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Provider Name | JOHN A CAVALLO M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/01/2006
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Last Update Date | 04/09/2024
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Provider Practice Location Address
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Address Line | 1 DONALD'S WAY STE 200
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City | EAST BRIDGEWATER
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State | MA
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Zip | 02333-1464
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Country | US
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Telephone | 508-940-0400
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Fax | 508-894-0412
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Provider Business Mailing Address
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Address Line | 1 COMPASS WAY STE 200
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City | E BRIDGEWATER
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State | MA
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Zip | 02333-1464
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Country | US
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Telephone | 508-697-3677
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Fax | 508-894-0412
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 158340
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License Number State | MA
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