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Individual
ADAM CASEY
Active
Individual
ADAM CASEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085006708
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
085006708
IL PHYSICIAN ASSISTANT LICENSE
IL
Enumeration date
10/04/2018
Last updated
09/11/2019
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