Individual
MATTHEW CASEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
339 CONSORT DR, BALLWIN, MO 63011-4439
(636) 386-9224
(636) 386-7679
Mailing address
339 CONSORT DR, BALLWIN, MO 63011-4439
(636) 386-9224
(636) 386-7679
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
036-115992
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036115992
—
IL
Enumeration date
07/12/2006
Last updated
03/09/2011
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