Provider Demographics
NPI:1831305085
Name:CAVICCHIA MILLER, CANDICE (MD)
Entity Type:Individual
Prefix:
First Name:CANDICE
Middle Name:
Last Name:CAVICCHIA MILLER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CANDICE
Other - Middle Name:MICHELLE
Other - Last Name:CAVICCHIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:240 N 7TH ST STE 500
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:PA
Mailing Address - Zip Code:17501-1366
Mailing Address - Country:US
Mailing Address - Phone:717-278-3850
Mailing Address - Fax:717-402-9113
Practice Address - Street 1:240 N 7TH ST STE 500
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:PA
Practice Address - Zip Code:17501-1366
Practice Address - Country:US
Practice Address - Phone:717-278-3850
Practice Address - Fax:717-402-9113
Is Sole Proprietor?:No
Enumeration Date:2007-05-15
Last Update Date:2022-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT190398390200000X
PAMD438696207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program