Individual
MUTHALIB M CASSIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
913 11TH ST SE, BANDON, OR 97411-9168
(541) 347-2426
(541) 347-3923
Mailing address
900 11TH ST SE, BANDON, OR 97411-9114
(541) 347-2426
(541) 347-3923
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
MD11038
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
057083
—
OR
Enumeration date
11/10/2006
Last updated
07/27/2021
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