Cannon, Michael

Cannon, Michael is an individual health care provider with primary practice located at 933 First Colonial Rd Suite 100, Virginia Beach VA 23454-3172. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Cannon, Michael can be contacted via phone (757) 491-7359.

Contact Information

Primary practice address
933 First Colonial Rd Suite 100 Virginia Beach VA 23454-3172
Fax: (757) 491-9359
Website:

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 0101229742 Virginia

Profile Details

NPI number 1215925599
LBN Legal business name Cannon, Michael
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 11th, 2005
Last updated Nov 10th, 2017 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1215925599 NPPES
North Carolina Other 59000245 NC MEDICAID
North Carolina Other 175136 NC MEDICAID
North Carolina Other 175136 NC MEDICAID
North Carolina Other 93867 NC MEDICAID
North Carolina Other 010137594 NC MEDICAID
North Carolina MEDICAID 010137594 NC MEDICAID

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