Individual
CASSANDRA EVANS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
501 REDMOND RD NW, ROME, GA 30165-1415
(706) 291-0291
Mailing address
2268 REINHARDT COLLEGE PKWY, CANTON, GA 30114-2064
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
018860
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000273237E
—
GA
05
—
000273237G
—
GA
01
—
GRP4155
MEDICARE GROUP NUMBER
GA
Enumeration date
06/16/2006
Last updated
10/08/2008
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