Provider Demographics
NPI:1629397112
Name:MCDANIEL, CASSANDRA B (MD)
Entity Type:Individual
Prefix:DR
First Name:CASSANDRA
Middle Name:B
Last Name:MCDANIEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:5450 KNOLL NORTH DR
Mailing Address - Street 2:SUITE 300
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21045-2373
Mailing Address - Country:US
Mailing Address - Phone:410-964-6300
Mailing Address - Fax:410-964-6227
Practice Address - Street 1:5450 KNOLL NORTH DR
Practice Address - Street 2:SUITE 300
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21045-2373
Practice Address - Country:US
Practice Address - Phone:410-964-6300
Practice Address - Fax:410-964-6227
Is Sole Proprietor?:No
Enumeration Date:2010-05-23
Last Update Date:2014-09-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD75700208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics