MEDICARE: DR. MATHEW M CANNAVA M.D.

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	207N00000X	Dermatology Physician	AK4179	AK
2	207ND0101X	MOHS-Micrographic Surgery Physician	AK4179	AK
3	207ND0900X	Dermatopathology Physician	AK4179	AK
4	207NI0002X	Clinical & Laboratory Dermatological Immunology Physician	AK4179	AK
5	207NP0225X	Pediatric Dermatology Physician	AK4179	AK
6	207NS0135X	Procedural Dermatology Physician	AK4179	AK

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1245368695
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MATHEW M CANNAVA M.D.

Provider Business Mailing Address
First Line	:	PO BOX 780
Second Line	:
City	:	SOLDOTNA
State	:	AK
Zip	:	99669-0780
Country	:	US
Telephone Number	:	907-262-7546
Fax Number	:	907-262-7599

Provider Business Practice Location Address
First Line	:	247 N FIREWEED ST
Second Line	:	STE B
City	:	SOLDOTNA
State	:	AK
Zip	:	99669-7540
Country	:	US
Telephone Number	:	907-262-7546
Fax Number	:	907-262-7599

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

Provider Enumeration Date	:	02/28/2007
Last Update Date	:	02/10/2009

Similar Medicare Providers

1649273897 — DR. DAVID E CHAMBERS MD
Practice Location Address:

247 N FIREWEED ST , SUITE B
SOLDOTNA, AK
99669-7540

Practice Phone: 907-561-3211
Practice Fax: 907-562-7547

1659355675 — FRANCES STIER FNP
Practice Location Address:

247 N FIREWEED ST , SUITE B
SOLDOTNA, AK
99669-7540

Practice Phone: 907-561-3211
Practice Fax: 907-562-7547

1285661959 — PENINSULA INTERNAL MEDICINE PC
Practice Location Address:

247 N FIREWEED ST , STE A
SOLDOTNA, AK
99669-7540

Practice Phone: 907-262-8597
Practice Fax: 907-262-6516

1477658540 — DR. TRICIA BUTTON ELLIOTT MCDONAGH M.D.
Practice Location Address:

247 N FIREWEED ST , SUITE A
SOLDOTNA, AK
99669-7540

Practice Phone: 907-262-8597
Practice Fax: 907-262-6516

1205917671 — MR. WILLIAM E NEWBERRY PA-C
Practice Location Address:

247 N FIREWEED ST , SUITE A
SOLDOTNA, AK
99669-7540

Practice Phone: 907-262-8597
Practice Fax: 907-262-6516

1174729123 — ASPEN PHYSICAL THERAPY PC
Practice Location Address:

221 W. MARYDALE AVE
SOLDOTNA, AK
99669-7540

Practice Phone: 907-262-2596
Practice Fax:

Directions to “ DR. MATHEW M CANNAVA M.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.