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General NPI Number Information
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NPI Number | 1104824663
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Entity Type | Organization
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Legal Business Name | AMERICAN ONCOLOGIC ASSOCIATES OF CAMBRIDGE, INC
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Dates
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Enumeration Date | 07/08/2005
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 1410 CLARK ST
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City | CAMBRIDGE
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State | OH
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Zip | 43725-9617
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Country | US
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Telephone | 304-422-3398
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Fax | 304-485-4466
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Provider Business Mailing Address
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Address Line | PO BOX 779
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City | PARKERSBURG
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State | WV
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Zip | 26102-0779
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Country | US
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Telephone | 304-422-3398
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Fax | 304-485-4466
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Authorized Official
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Title or Position | PRESIDENT
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Name | SRINI VASAN
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Credential | M.D.
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Telephone | 304-422-3398
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number |
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License Number State |
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