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NPI Code Detail

MEDICARE: DR. DOUGLAS EDWARD CANHAM MD

MEDICARE: DR. DOUGLAS EDWARD CANHAM 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
1207P00000XEmergency Medicine Physician11356NV
2207P00000XEmergency Medicine Physician17440CO

General Provider Information

NPI Number : 1588640445
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DOUGLAS EDWARD CANHAM MD
Provider Business Mailing Address
First Line : 2610 STRATHMORE CT
Second Line :
City : RENO
State : NV
Zip : 89521-6231
Country : US
Telephone Number : 775-851-1056
Fax Number : 775-851-7680
Provider Business Practice Location Address
First Line : 18653 WEDGE PKWY
Second Line :
City : RENO
State : NV
Zip : 89511-3005
Country : US
Telephone Number : 775-770-7210
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/21/2005
Last Update Date : 07/09/2007

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