Provider Demographics
NPI:1487786869
Name:KAVANAUGH, MICHAEL JOSEPH (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:JOSEPH
Last Name:KAVANAUGH
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:NAVAL MEDICAL CENTER PORTSMOUTH
Mailing Address - Street 2:620 JOHN PAUL JONES CIRCLE, BLD 2, FL 2(INTERNAL MED)
Mailing Address - City:PORTSMOUTH
Mailing Address - State:VA
Mailing Address - Zip Code:23708-2197
Mailing Address - Country:US
Mailing Address - Phone:757-953-4026
Mailing Address - Fax:757-953-2360
Practice Address - Street 1:NAVAL MEDICAL CENTER PORTSMOUTH
Practice Address - Street 2:620 JOHN PAUL JONES CIRCLE, BLD 2, FL 2(INTERNAL MED)
Practice Address - City:PORTSMOUTH
Practice Address - State:VA
Practice Address - Zip Code:23708-2197
Practice Address - Country:US
Practice Address - Phone:757-953-4026
Practice Address - Fax:757-953-2360
Is Sole Proprietor?:No
Enumeration Date:2007-03-11
Last Update Date:2023-08-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMD4655330207RC0200X
VA0101240250207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine