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Individual

EZEQUIEL HERNAN CASSINELLI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
059053
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000503683
ANTHEM
01
0486290001
DME
01
203287
UNISON
05
2409521
OH
01
7848618
AETNA
01
P00242139
RAILROAD MEDICARE
OH
01
P00364266
MCR RR
Enumeration date
07/12/2006
Last updated
10/22/2010
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