MEDICARE: DR. JAMES C CASSANDRA M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2086S0105X	Surgery of the Hand (Surgery) Physician	34.007878	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1104891605
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES C CASSANDRA M.D.

Provider Business Mailing Address
First Line	:	70 S CLEVELAND AVE
Second Line	:
City	:	WESTERVILLE
State	:	OH
Zip	:	43081-1397
Country	:	US
Telephone Number	:	614-890-6555
Fax Number	:

Provider Business Practice Location Address
First Line	:	1325 STRINGTOWN RD STE 280
Second Line	:
City	:	GROVE CITY
State	:	OH
Zip	:	43123
Country	:	US
Telephone Number	:	614-890-6555
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/20/2006
Last Update Date	:	11/19/2021

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