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General NPI Number Information
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NPI Number | 1720171283
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Entity Type | Individual
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Provider Name | DEBORAH SUSAN CAVANAUGH MD
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Gender | Female
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Dates
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Enumeration Date | 10/02/2006
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Last Update Date | 02/25/2025
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Provider Practice Location Address
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Address Line | 836 5TH AVE
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City | BELLE FOURCHE
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State | SD
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Zip | 57717-1607
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Country | US
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Telephone | 832-604-3771
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Fax |
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Provider Business Mailing Address
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Address Line | 73-4331 KAKAHIAKA ST
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City | KAILUA KONA
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State | HI
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Zip | 96740-9548
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Country | US
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Telephone | 605-321-2549
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 5199
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License Number State | SD
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | MD-23081
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License Number State | HI
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Taxonomy #3
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 45523
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License Number State | MN
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