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NPI Code Detail

MEDICARE: CONOR KASABO MD

MEDICARE:   CONOR  KASABO  MD
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
1208D00000XGeneral Practice Physician0101273778VA
22084P0800XPsychiatry Physician0101273778VA

General Provider Information

NPI Number : 1669001251
Entity Type Code : Individual
Provider Name (Legal Business Name) : CONOR KASABO MD
Provider Business Mailing Address
First Line : 2817 ROCK MERRITT AVENUE
Second Line :
City : FORT LIBERTY
State : NC
Zip : 28310-0001
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2817 ROCK MERRITT AVENUE
Second Line :
City : FORT LIBERTY
State : NC
Zip : 28310-0004
Country : US
Telephone Number : 301-295-1100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/06/2020
Last Update Date : 07/04/2024

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Directions to “ CONOR KASABO MD” Practice Location

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