Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0003X | Hematology & Oncology | 4301076035 | MI |
NPI | 1013975903 |
---|---|
Provider Name | Timothy C Kasunic |
First Address | Toledo, OH 43623-4231 |
Second Address | Toledo, OH 43623-4231 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/05/2006 |
Last Update Date | 31/05/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2673558 | (05) | OH |
I53491 | (02) | |
P00323978 | RAILROAD MEDICARE (01) |