Individual
DR. KATHERINE L CASSIDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1316 E 7TH ST, AUBURN, IN 46706-2538
(260) 373-4000
(260) 482-4442
Mailing address
608 UNION CHAPEL RD, FORT WAYNE, IN 46845-9357
(260) 482-4440
(260) 482-4442
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
01054605A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000010974
MPLAN
—
01
—
000000214697
ANTHEM
IN
01
—
047840VVV
MEDICARE WPS/CMS
—
05
—
104874614
—
MI
05
—
200364960
—
IN
05
—
2521284
—
OH
01
—
930113729
RR MEDICARE
—
Enumeration date
09/12/2005
Last updated
05/09/2024
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