Individual
DR. CASSANDRA MIERISCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M. D.
Contact information
Practice address
2331 FRANKLIN RD SW, ROANOKE, VA 24014-1111
(540) 725-1226
(540) 857-5306
Mailing address
2331 FRANKLIN RD SW, ROANOKE, VA 24014-1111
(540) 725-1226
(540) 857-5306
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
0101242071
VA
207XS0106X
Orthopaedic Hand Surgery Physician
Primary
0101242071
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1760672489
UNITED HEALTHCARE
VA
05
—
1760672489
—
VA
01
—
371194700
BLACK LUNG
VA
01
—
3810010540
MEDICAID OF WVA
VA
01
—
540506332004
TRICARE
VA
01
—
761760
MEDICAID OF NORTH CAROLINA
VA
01
—
P00450222
RAILROAD MEDICARE
VA
Enumeration date
07/30/2007
Last updated
01/25/2016
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