Provider Demographics
NPI:1528037090
Name:CAHOON, STEPHEN ERIC (PA-C)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:ERIC
Last Name:CAHOON
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:396 ROUTE 6 AND 209
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:PA
Mailing Address - Zip Code:18337-9490
Mailing Address - Country:US
Mailing Address - Phone:570-296-4901
Mailing Address - Fax:570-296-5480
Practice Address - Street 1:510 ROUTE 6 AND 209 STE 103
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:PA
Practice Address - Zip Code:18337-7615
Practice Address - Country:US
Practice Address - Phone:570-296-4901
Practice Address - Fax:570-296-5480
Is Sole Proprietor?:No
Enumeration Date:2006-03-16
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA053323363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1033497100002Medicaid
PA1033497100004Medicaid
PA1033497100001Medicaid
PA1033497100003Medicaid