Cannon, Michael Louis

Cannon, Michael Louis is an individual health care provider with primary practice located at Medical Center Blvd , Winston Salem NC 27157-0001. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatric Critical Care Medicine, which is considered as his primary health care specialty. Cannon, Michael Louis can be contacted via phone (336) 716-2255.

Contact Information

Primary practice address
Medical Center Blvd Winston Salem NC 27157-0001
Phone: (336) 716-2255
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatric Critical Care Medicine 2080P0203X 0095-00033 North Carolina

Profile Details

NPI number 1578540076
LBN Legal business name Cannon, Michael Louis
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 27th, 2005
Last updated Nov 11th, 2016 - about 8 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 1578540076 NPPES
North Carolina Other 5445723 AETNA
North Carolina MEDICAID 891131R AETNA
North Carolina Other 1131R AETNA
North Carolina MEDICAID 2004805000 AETNA
North Carolina Other 79555 AETNA
North Carolina MEDICAID 6729746 AETNA
North Carolina Other 24396 AETNA
North Carolina MEDICAID Q00031 AETNA

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