MEDICARE: LEO MAXWELL CASS 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
1	174400000X	Specialist	33744	MA

General Provider Information

NPI Number	:	1033158795
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LEO MAXWELL CASS M.D.

Provider Business Mailing Address
First Line	:	PO BOX 2706
Second Line	:
City	:	WOBURN
State	:	MA
Zip	:	01888-1306
Country	:	US
Telephone Number	:	781-721-5025
Fax Number	:	781-729-2297

Provider Business Practice Location Address
First Line	:	223 SWANTON ST
Second Line	:
City	:	WINCHESTER
State	:	MA
Zip	:	01890-1968
Country	:	US
Telephone Number	:	781-721-5025
Fax Number	:	781-729-2297

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/06/2006
Last Update Date	:	03/17/2018

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