Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0201X | Gynecologic Oncologist | 35.128121 | OH |
NPI | 1124387006 |
---|---|
Provider Name | Casey Cosgrove |
First Address | Columbus, OH 43202-1559 |
Second Address | Hilliard, OH 43026-7752 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/05/2012 |
Last Update Date | 05/03/2021 |