Casey, Matthew

Casey, Matthew is an individual health care provider with primary practice located at 339 Consort Dr , Ballwin MO 63011-4439. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anesthesiology, which is considered as his primary health care specialty. Casey, Matthew can be contacted via phone (636) 386-9224.

Contact Information

Primary practice address
339 Consort Dr Ballwin MO 63011-4439
Fax: (636) 386-7679
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X 036-115992 Illinois

Profile Details

NPI number 1912922014
LBN Legal business name Casey, Matthew
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 12th, 2006
Last updated Mar 9th, 2011 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1912922014 NPPES
Illinois MEDICAID 036115992

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