Provider Demographics
NPI:1043649015
Name:CANNING, PATRICK (MB,BCHBAO)
Entity Type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:
Last Name:CANNING
Suffix:
Gender:M
Credentials:MB,BCHBAO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1129 WOODWIND TRL
Mailing Address - Street 2:
Mailing Address - City:HASLETT
Mailing Address - State:MI
Mailing Address - Zip Code:48840-8956
Mailing Address - Country:US
Mailing Address - Phone:517-339-2630
Mailing Address - Fax:
Practice Address - Street 1:1129 WOODWIND TRL
Practice Address - Street 2:
Practice Address - City:HASLETT
Practice Address - State:MI
Practice Address - Zip Code:48840-8956
Practice Address - Country:US
Practice Address - Phone:517-339-2630
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-10
Last Update Date:2013-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301031361207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology