Kavanaugh, Kevin M

Kavanaugh, Kevin M is an individual health care provider with primary practice located at 122 W 7Th Ave Suite 310, Spokane WA 99204-2349. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Cardiovascular Disease, Allopathic & Osteopathic Physicians / Interventional Cardiology. Allopathic & Osteopathic Physicians / Interventional Cardiology is his primary health care specialty. Kavanaugh, Kevin M can be contacted via phone (509) 838-7711.

Contact Information

Primary practice address
122 W 7Th Ave Suite 310 Spokane WA 99204-2349
Fax: (509) 747-4664
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X MD31738 Washington
Allopathic & Osteopathic Physicians / Interventional Cardiology 207RI0011X MD00031738 Washington

Profile Details

NPI number 1205889433
LBN Legal business name Kavanaugh, Kevin M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 18th, 2006
Last updated Dec 31st, 2015 - about 9 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 1205889433 NPPES
Idaho Other M6627 IDAHO LICENSE
Idaho Other MD00031738 IDAHO LICENSE
Idaho MEDICAID 003213300 IDAHO LICENSE

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