MEDICARE: MICHAEL KEVIN CAVANAGH MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	35147	CO

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	080126302	OTHER	CO	MEDICARE RAILROAD

General Provider Information

NPI Number	:	1033161955
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL KEVIN CAVANAGH MD

Provider Business Mailing Address
First Line	:	12201 PECOS ST
Second Line	:	SUITE 500
City	:	WESTMINSTER
State	:	CO
Zip	:	80234-3888
Country	:	US
Telephone Number	:	303-457-4497
Fax Number	:	303-450-4692

Provider Business Practice Location Address
First Line	:	12201 PECOS ST
Second Line	:	UNIT 500
City	:	WESTMINSTER
State	:	CO
Zip	:	80234-3888
Country	:	US
Telephone Number	:	303-457-4497
Fax Number	:	303-450-4692

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/17/2006
Last Update Date	:	08/01/2025

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