Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2086S0120X | Pediatric Surgery | 01079052A | IN |
N | 2086S0120X | Pediatric Surgery | 30557 | OK |
Y | 2086S0120X | Pediatric Surgery | 35.131998 | OH |
N | 2086S0120X | Pediatric Surgery | L2175 | TX |
NPI | 1205916632 |
---|---|
Provider Name | Dr. Darrell L. Cass |
First Address | Cleveland, OH 44195-0001 |
Second Address | Cleveland, OH 44195-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/10/2006 |
Last Update Date | 28/05/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
144498601 | (05) | TX |
144498602 | (05) | TX |
144498604 | (05) | TX |
144498605 | CSHCN (01) | TX |
H38886 | (02) |