Provider Demographics
NPI:1811961535
Name:CADENA, MICHAEL E (DO)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:E
Last Name:CADENA
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 781076
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48278-1076
Mailing Address - Country:US
Mailing Address - Phone:317-528-4800
Mailing Address - Fax:317-865-1479
Practice Address - Street 1:12750 ST FRANCIS DR
Practice Address - Street 2:
Practice Address - City:CROWN POINT
Practice Address - State:IN
Practice Address - Zip Code:46307-0264
Practice Address - Country:US
Practice Address - Phone:219-757-6331
Practice Address - Fax:219-757-6481
Is Sole Proprietor?:No
Enumeration Date:2006-02-17
Last Update Date:2024-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM2226207V00000X, 207VG0400X, 207VX0000X
IN02004504A207V00000X, 207VG0400X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
No207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX08NAOtherBLUECROSSBLUESHIELD
IN201257250Medicaid
TX179575901Medicaid
TX1811961535Medicaid
IN201257250Medicaid
TXI49150Medicare UPIN
IN471400258Medicare PIN