Provider Demographics
NPI:1366854051
Name:CAVADINI, LAURA ANNE (DO)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:ANNE
Last Name:CAVADINI
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:ANNE
Other - Last Name:LOMBARDINI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:230 E DAY RD
Mailing Address - Street 2:STE 100
Mailing Address - City:MISHAWAKA
Mailing Address - State:IN
Mailing Address - Zip Code:46545-3408
Mailing Address - Country:US
Mailing Address - Phone:574-271-3939
Mailing Address - Fax:574-271-3941
Practice Address - Street 1:230 E DAY RD STE 100
Practice Address - Street 2:
Practice Address - City:MISHAWAKA
Practice Address - State:IN
Practice Address - Zip Code:46545
Practice Address - Country:US
Practice Address - Phone:574-271-3939
Practice Address - Fax:574-271-3941
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-29
Last Update Date:2018-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101020963207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology