Provider Demographics
NPI:1164913299
Name:CAHILL, CAROLINE (MD)
Entity type:Individual
Prefix:DR
First Name:CAROLINE
Middle Name:
Last Name:CAHILL
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:NAVAL MEDICAL CENTER SAN DIEGO 38400 BOB WILSON DRIVE
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92134-5000
Mailing Address - Country:US
Mailing Address - Phone:630-414-5480
Mailing Address - Fax:
Practice Address - Street 1:III MEF SURGEONS OFFICE
Practice Address - Street 2:UNIT 35605
Practice Address - City:FPO
Practice Address - State:AP
Practice Address - Zip Code:96382
Practice Address - Country:US
Practice Address - Phone:315-622-3066
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-24
Last Update Date:2024-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE18308208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA320143OtherLOUISIANA STATE LICENSE