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General NPI Number Information
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NPI Number | 1326049792
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Entity Type | Individual
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Provider Name | DANIEL K CASSAVAR MD
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Gender | Male
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Dates
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Enumeration Date | 08/09/2005
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Last Update Date | 11/03/2023
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Provider Practice Location Address
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Address Line | 1601 BRIGHAM DR STE 120
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City | PERRYSBURG
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State | OH
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Zip | 43551-7121
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Country | US
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Telephone | 419-872-7703
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Fax | 419-872-1704
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Provider Business Mailing Address
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Address Line | 1601 BRIGHAM DR STE 120
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City | PERRYSBURG
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State | OH
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Zip | 43551-7121
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Country | US
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Telephone | 419-872-7703
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Fax | 419-872-1704
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 35.064640
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License Number State | OH
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