Provider Demographics
NPI:1447338413
Name:CAVALIERE, MARIA (MD)
Entity type:Individual
Prefix:DR
First Name:MARIA
Middle Name:
Last Name:CAVALIERE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:682 HEMLOCK ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31201-6883
Mailing Address - Country:US
Mailing Address - Phone:478-746-0901
Mailing Address - Fax:478-330-6150
Practice Address - Street 1:682 HEMLOCK ST
Practice Address - Street 2:SUITE 200
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31201-6883
Practice Address - Country:US
Practice Address - Phone:478-746-0901
Practice Address - Fax:478-330-6150
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2017-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA055662207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA1689826315OtherGROUP NPI
GAP00706992OtherRAILROAD MEDICARE PTAN
GADO7908OtherRAILROAD MCARE GRP #
GA594949079EMedicaid
GA1447338413OtherIND NPI
GA594949079AMedicaid
GA1689826315OtherGROUP NPI