Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 35079170 | OH |
Y | 207QG0300X | Family Doctor - Geriatric Medicine | 35079170 | OH |
NPI | 1033195698 |
---|---|
Provider Name | James Donald Cassady |
First Address | Cleveland, OH 44193-0018 |
Second Address | Columbus, OH 43213-1574 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/12/2005 |
Last Update Date | 08/11/2007 |