Male or Other

Dr. Michael Kavkewitz PH. D.

Full Name

Dr. Michael Kavkewitz PH. D.

NPI Number

1598814394

NPI Type

Individual Provider

Gender

Male

Enumeration Date

01/09/2007

Specialties

(Taxonomies)

Code

103TC0700X
103TC1900X

Primary Taxonomy

No
No

Licenses

State

Georgia
Tennessee

License Number

864
P001108

Contact
Information

Purpose

Mailing
Location

Address

103 TUXEDO CIR
6727 HERITAGE BUSINESS CT

City

Chattanooga
Chattanooga

State

TN
TN

Postal Code

37411-4618
37421-7015

Country

US
US

Telephone Number

N/A
(423) 314-1176

Identifiers

Identifier

0090222
00389914D

Identifier State

TN
GA

Identifier Issuer

BCBS-TN PROVIDER ID
Unknown

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 07/08/2007

Provider Address