NPI 1215468814 · live from the CMS NPI Registry
Michael Coyne Kavanaugh, MD
Radiology, Diagnostic Radiology in Providence, RI. National Provider Identifier 1215468814, active.
NPI record
| NPI | 1215468814 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Radiology, Diagnostic Radiology 2085R0202X |
| Practice location | 593 Eddy St, Providence, RI 02903 |
| Practice phone | 401-444-4000 |
| Mailing address | 125 Metro Center Blvd Ste 2000, Warwick, RI 02886 |
| Enumerated | March 24, 2017 |
| Last updated | April 5, 2024 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | — |
| Radiology, Diagnostic Radiology primary | 2085R0202X | MD17199 (RI) |
| Radiology, Diagnostic Radiology | 2085R0202X | 1013402 (MA) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.