Cavanaugh, Gregory M
Cavanaugh, Gregory M is an individual health care provider with primary practice located at 4131 W. Loomis Rd. Ste 300, Greenfield WI 53221-2059. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Cavanaugh, Gregory M can be contacted via phone (414) 325-7246.Contact Information
Primary practice address
4131 W. Loomis Rd. Ste 300
Greenfield WI 53221-2059
Phone: (414) 325-7246
Fax: (414) 325-3770
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | 1261023 | Wisconsin |
Profile Details
| NPI number | 1124084462 |
|---|---|
| LBN Legal business name | Cavanaugh, Gregory M |
| Credentials | Physician's Assistant Certified (PA-C) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 25th, 2006 |
| Last updated | Feb 24th, 2014 - about 10 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 | 1124084462 | NPPES |
| Wisconsin | MEDICAID | 30118100 |
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