Provider Demographics
NPI:1790300275
Name:CAWLEY, CARA NICOLE (DO)
Entity Type:Individual
Prefix:
First Name:CARA
Middle Name:NICOLE
Last Name:CAWLEY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1215 E MICHIGAN AVE
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48912-1896
Mailing Address - Country:US
Mailing Address - Phone:512-432-9277
Mailing Address - Fax:517-432-9414
Practice Address - Street 1:1215 E MICHIGAN AVE
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48912-1811
Practice Address - Country:US
Practice Address - Phone:512-432-9277
Practice Address - Fax:512-432-9414
Is Sole Proprietor?:No
Enumeration Date:2020-06-10
Last Update Date:2020-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI390200000X2084N0400X
MI51510145262084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology