| Doctor Name: | JAMEN ANDREW CAVALLIER |
| NPI Number: | 1184971400 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PA |
| License Number: | 0010-05860 |
| Business Practice Address: | 1388 Sand Hill Rd Candler, NC - 287158937 |
| Business Phone Number: | 8282133717 |
| Business Fax Number: | |
| Mailing Address: | Po Box 602373, CHARLOTTE |
| State: | NC |
| Postal Code: | 282602373 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 08/06/2012 |
| NPI Last Update Date: | 08/03/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | 0010-05860 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NC |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |