Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 40019 | CO |
N | 207VG0400X | Gynecologist | DR.0040019 | CO |
NPI | 1043251572 |
---|---|
Provider Name | Dr. Meredith S. Cassidy |
First Address | Colorado Springs, CO 80923-2607 |
Second Address | Colorado Springs, CO 80923-2607 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2006 |
Last Update Date | 23/04/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
17005736 | (05) | CO |