Provider Demographics
NPI:1073695565
Name:CASP, WILLIAM JOSEPH (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:JOSEPH
Last Name:CASP
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 E GROVER ST
Mailing Address - Street 2:
Mailing Address - City:SHELBY
Mailing Address - State:NC
Mailing Address - Zip Code:28150-3919
Mailing Address - Country:US
Mailing Address - Phone:704-424-5100
Mailing Address - Fax:704-484-5220
Practice Address - Street 1:315 E GROVER ST
Practice Address - Street 2:
Practice Address - City:SHELBY
Practice Address - State:NC
Practice Address - Zip Code:28150-3919
Practice Address - Country:US
Practice Address - Phone:704-424-5100
Practice Address - Fax:704-484-5220
Is Sole Proprietor?:No
Enumeration Date:2006-10-20
Last Update Date:2009-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC28150207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89014YEMedicaid
NC89014YEMedicaid
NCC83170Medicare UPIN