Provider Demographics
NPI:1164984191
Name:CASHAW-DAVIS, RODNEY ROMAN
Entity Type:Individual
Prefix:
First Name:RODNEY
Middle Name:ROMAN
Last Name:CASHAW-DAVIS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:RODNEY
Other - Middle Name:ROMAN
Other - Last Name:DAVIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1409 HILDRETH AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43203-1605
Mailing Address - Country:US
Mailing Address - Phone:614-804-0840
Mailing Address - Fax:
Practice Address - Street 1:1409 HILDRETH AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43203-1605
Practice Address - Country:US
Practice Address - Phone:614-804-0840
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-31
Last Update Date:2019-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH00235175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist