Provider Demographics
NPI:1992845812
Name:CADWELL, MICHAEL WARD (MS)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:WARD
Last Name:CADWELL
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2873 WALLACE LAKE RD
Mailing Address - Street 2:
Mailing Address - City:PACE
Mailing Address - State:FL
Mailing Address - Zip Code:32571
Mailing Address - Country:US
Mailing Address - Phone:850-994-0282
Mailing Address - Fax:
Practice Address - Street 1:2873 WALLACE LAKE RD
Practice Address - Street 2:
Practice Address - City:PACE
Practice Address - State:FL
Practice Address - Zip Code:32571-9171
Practice Address - Country:US
Practice Address - Phone:850-994-0282
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-08
Last Update Date:2009-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health