Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0001X | Advanced Heart Failure and Transplant Cardiologist | 3193 | WV |
N | 207RC0000X | Internist - Cardiovascular Disease | 02004222A | IN |
N | 207RC0000X | Internist - Cardiovascular Disease | 393 | WV |
N | 207RC0000X | Internist - Cardiovascular Disease | 52173 | MN |
N | 207RC0000X | Internist - Cardiovascular Disease | OS015872 | PA |
NPI | 1164696530 |
---|---|
Provider Name | Dr. Marco A Caccamo |
First Address | Morgantown, WV 26506-1200 |
Second Address | Morgantown, WV 26506-1200 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/04/2008 |
Last Update Date | 09/01/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
201164930 | (05) | IN |
P01238575 | RAILROAD MEDICARE (01) | IN |
P01279017 | RAILROAD MEDICARE (01) | IN |