Individual
DR. JOHN RICHARD CASUCCIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2000 FOUNDATION WAY STE 3650, MARTINSBURG, WV 25401-9197
(304) 350-3274
(304) 350-3404
Mailing address
2500 FOUNDATION WAY, MARTINSBURG, WV 25401-9000
(304) 264-9202
(304) 264-9042
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
0101042197
VA
2086S0120X
Pediatric Surgery Physician
Primary
12657
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810011293
—
WV
Enumeration date
01/25/2006
Last updated
01/08/2015
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