Provider Demographics
NPI:1134385222
Name:JOHN W CAVENDISH II MD
Entity type:Organization
Organization Name:JOHN W CAVENDISH II MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:W
Authorized Official - Last Name:CAVENDISH
Authorized Official - Suffix:II
Authorized Official - Credentials:MD
Authorized Official - Phone:989-790-3450
Mailing Address - Street 1:2110 N MORSON ST
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48602-3456
Mailing Address - Country:US
Mailing Address - Phone:989-790-3450
Mailing Address - Fax:
Practice Address - Street 1:2110 N MORSON ST
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48602-3456
Practice Address - Country:US
Practice Address - Phone:989-790-3450
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-29
Last Update Date:2008-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty