Basic Information
| Provider Information | |||||||||
| NPI: | 1164849329 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SAL CAVALIERE, DO., PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4385 BENNETT PARK CIR | ||||||||
| Address2: | |||||||||
| City: | TROY | ||||||||
| State: | MI | ||||||||
| PostalCode: | 480855729 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5862421415 | ||||||||
| FaxNumber: | 5867256842 | ||||||||
| Practice Location | |||||||||
| Address1: | 6071 W OUTER DR | ||||||||
| Address2: | SELECT SPECIALITY HOSPITAL | ||||||||
| City: | DETROIT | ||||||||
| State: | MI | ||||||||
| PostalCode: | 482352624 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3139663300 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/26/2014 | ||||||||
| LastUpdateDate: | 05/11/2017 | ||||||||
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| AuthorizedOfficialLastName: | CAVALIERE | ||||||||
| AuthorizedOfficialFirstName: | SALVATORE | ||||||||
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| AuthorizedOfficialTitleorPosition: | DR/OWNER | ||||||||
| AuthorizedOfficialTelephone: | 5862421415 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | D.O. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Y00000X | 5101011226 | MI | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Otolaryngology | 207YX0905X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Otolaryngology | Otolaryngology/Facial Plastic Surgery |
No ID Information.