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
Phone: (509) 838-7711
Fax: (509) 747-4664
Website:
Health care specialties
Specialty | Code | License # | 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1205889433 | NPPES |
Idaho | Other | M6627 | IDAHO LICENSE |
Idaho | Other | MD00031738 | IDAHO LICENSE |
Idaho | MEDICAID | 003213300 | IDAHO LICENSE |
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