Provider Demographics
NPI:1326044256
Name:CAHILL, DAVID M (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:M
Last Name:CAHILL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:15 MEADE ST
Mailing Address - Street 2:STE L5
Mailing Address - City:WELLSBORO
Mailing Address - State:PA
Mailing Address - Zip Code:16901-1813
Mailing Address - Country:US
Mailing Address - Phone:570-724-4670
Mailing Address - Fax:570-724-3896
Practice Address - Street 1:15 MEADE ST
Practice Address - Street 2:STE L5
Practice Address - City:WELLSBORO
Practice Address - State:PA
Practice Address - Zip Code:16901-1813
Practice Address - Country:US
Practice Address - Phone:570-724-4670
Practice Address - Fax:570-724-3896
Is Sole Proprietor?:No
Enumeration Date:2005-06-24
Last Update Date:2009-11-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD036511E208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001057474002Medicaid
PA427942Medicare PIN
PA001057474002Medicaid