Basic Information
| Provider Information | |||||||||
| NPI: | 1790004984 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CAVANAUGH | ||||||||
| FirstName: | DANIEL | ||||||||
| MiddleName: | LEE | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 130 MASON FARM RD | ||||||||
| Address2: | DEPARTMENT ORTHOPAEDICS, CB# 7055 | ||||||||
| City: | CHAPEL HILL | ||||||||
| State: | NC | ||||||||
| PostalCode: | 275996134 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9199669071 | ||||||||
| FaxNumber: | 9199666730 | ||||||||
| Practice Location | |||||||||
| Address1: | 130 MASON FARM RD | ||||||||
| Address2: | DEPARTMENT ORTHOPAEDICS, CB# 7055 | ||||||||
| City: | CHAPEL HILL | ||||||||
| State: | NC | ||||||||
| PostalCode: | 275996134 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9199669071 | ||||||||
| FaxNumber: | 9199666730 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/27/2010 | ||||||||
| LastUpdateDate: | 10/21/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207XS0117X | 166376 | NC | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Orthopaedic Surgery of the Spine |
No ID Information.