Provider Demographics
NPI:1659534931
Name:NAUMOFF, CASEY ANDREW (MD)
Entity Type:Individual
Prefix:
First Name:CASEY
Middle Name:ANDREW
Last Name:NAUMOFF
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2510 5TH ST BLDG 840
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45433-7951
Mailing Address - Country:US
Mailing Address - Phone:937-938-2744
Mailing Address - Fax:937-904-8946
Practice Address - Street 1:4881 SUGAR MAPLE DR
Practice Address - Street 2:
Practice Address - City:WRIGHT PATTERSON AFB
Practice Address - State:OH
Practice Address - Zip Code:45433-5529
Practice Address - Country:US
Practice Address - Phone:937-257-9612
Practice Address - Fax:937-904-8946
Is Sole Proprietor?:No
Enumeration Date:2008-07-07
Last Update Date:2023-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01067737A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine