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General NPI Number Information
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NPI Number | 1528622040
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Entity Type | Individual
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Provider Name | CASSANDRA STEGALL DO
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Gender | Female
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Dates
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Enumeration Date | 04/30/2019
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Last Update Date | 06/09/2025
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Provider Practice Location Address
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Address Line | 3401 CIVIC CENTER BLVD DIVISION OF PEDIATRIC EMERGENCY MEDICINE
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City | PHILADELPHIA
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State | PA
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Zip | 19104
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Country | US
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Telephone | 215-590-1944
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Fax |
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Provider Business Mailing Address
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Address Line | 3401 CIVIC CENTER BLVD DIVISION OF PEDIATRIC EMERGENCY MEDICINE
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City | PHILADELPHIA
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State | PA
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Zip | 19104
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Country | US
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Telephone | 215-590-1944
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Fax |
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 0102207059
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 207PP0204X
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Taxonomy Name | Pediatric Emergency Medicine (Emergency Medicine) Physician
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License Number | 0102207059
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | LL82159
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License Number State | SC
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Taxonomy #4
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 0102207059
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License Number State | VA
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Taxonomy #5
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Taxonomy Code | 207PP0204X
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Taxonomy Name | Pediatric Emergency Medicine (Emergency Medicine) Physician
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License Number | OS024450
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License Number State | PA
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