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
Phone: (757) 491-7359
Fax: (757) 491-9359
Website:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| 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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