Individual
MARK N CASDORPH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
3130 N COUNTY ROAD 25A, TROY, OH 45373-1337
(937) 440-7305
(937) 440-7702
Mailing address
3170 KETTERING BLVD BLDG B3, MORAINE, OH 45439-1924
(937) 991-3188
(937) 223-9811
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
1322
WV
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
34.007158
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0004340531
AETNA
WV
05
—
0005355002
—
WV
01
—
000769253
BCBS
WV
05
—
0115895000
—
WV
01
—
1045755
WORKERS COMPENSATION
WV
01
—
2132198
MAMSI
WV
01
—
P00281739
RAILROAD MEDICARE
WV
Enumeration date
05/19/2006
Last updated
07/21/2022
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