Provider Demographics
NPI:1265485288
Name:KASIMER, WILLIAM D
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:D
Last Name:KASIMER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1342 BELMONT ST
Mailing Address - Street 2:SUITE 205
Mailing Address - City:BROCKTON
Mailing Address - State:MA
Mailing Address - Zip Code:02301-4436
Mailing Address - Country:US
Mailing Address - Phone:781-624-8397
Mailing Address - Fax:
Practice Address - Street 1:85 COLUMBIAN ST
Practice Address - Street 2:
Practice Address - City:WEYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02190-2416
Practice Address - Country:US
Practice Address - Phone:781-624-8397
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2015-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA60294207ZP0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAD87887Medicare UPIN
MA3042910Medicaid
MAJ08040Medicare PIN