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NPI Code Detail

MEDICARE: DR. SUSAN BLEASDALE CASEY M.D

MEDICARE: DR. SUSAN BLEASDALE CASEY 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
1207RI0200XInfectious Disease Physician01099550AIN
2207RI0200XInfectious Disease PhysicianD0101485MD
3207RI0200XInfectious Disease Physician036109313IL

General Provider Information

NPI Number : 1821058413
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SUSAN BLEASDALE CASEY M.D
Provider Business Mailing Address
First Line : 110 S PACA ST # 6N406
Second Line :
City : BALTIMORE
State : MD
Zip : 21201-1642
Country : US
Telephone Number : 410-328-1580
Fax Number :
Provider Business Practice Location Address
First Line : 7950 W JEFFERSON BLVD
Second Line :
City : FORT WAYNE
State : IN
Zip : 46804-4160
Country : US
Telephone Number : 260-435-7001
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/27/2006
Last Update Date : 05/05/2026

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