Provider Demographics
NPI:1093808917
Name:CURTIS, CASSANDRA E (MD)
Entity Type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:E
Last Name:CURTIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7151 MARSH RD STE 150
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46278-1631
Mailing Address - Country:US
Mailing Address - Phone:317-293-4113
Mailing Address - Fax:317-290-2542
Practice Address - Street 1:7151 MARSH RD STE 150
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46278-1631
Practice Address - Country:US
Practice Address - Phone:317-293-4113
Practice Address - Fax:317-290-2542
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2021-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN010547102084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200478890Medicaid
IN151560C3Medicare PIN
P00181095Medicare PIN
P00168258Medicare PIN
P00194299Medicare PIN
P00194299Medicare PIN
INI02841Medicare UPIN
P00168258Medicare PIN
IN151670GGMedicare PIN
IN151720EEMedicare PIN
IN151560C3Medicare PIN
IN152520KKMedicare PIN
P00181095Medicare PIN