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NPI Code Detail

MEDICARE: DR. MARYA L CASSANDRA DO

MEDICARE: DR. MARYA L CASSANDRA DO
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
1207N00000XDermatology Physician34.009168OH

General Provider Information

NPI Number : 1912979386
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARYA L CASSANDRA DO
Provider Business Mailing Address
First Line : 1047 PERRY ST
Second Line :
City : COLUMBUS
State : OH
Zip : 43201-3379
Country : US
Telephone Number : 614-777-1200
Fax Number :
Provider Business Practice Location Address
First Line : 3853 TRUEMAN CT
Second Line :
City : HILLIARD
State : OH
Zip : 43026-2496
Country : US
Telephone Number : 614-777-1200
Fax Number : 614-777-1294
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/01/2006
Last Update Date : 05/11/2011

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Directions to “ DR. MARYA L CASSANDRA DO” Practice Location

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