Individual
CASS CORTEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
8325 E SOUTHPORT RD STE 100, INDIANAPOLIS, IN 46259-6834
(317) 862-6609
(317) 862-4617
Mailing address
PO BOX 781076, DETROIT, MI 48278-1076
(317) 528-4800
(317) 865-1479
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01073551A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
136610003
MEDICARE PTAN
IN
05
—
201124720
—
IN
Enumeration date
06/28/2011
Last updated
04/26/2023
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