Provider Demographics
NPI:1659599272
Name:CASP INTERNAL MEDICINE
Entity Type:Organization
Organization Name:CASP INTERNAL MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:CASP
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:828-287-4840
Mailing Address - Street 1:668 POORS FORD RD
Mailing Address - Street 2:P.O. BOX 1960
Mailing Address - City:RUTHERFORDTON
Mailing Address - State:NC
Mailing Address - Zip Code:28139-4160
Mailing Address - Country:US
Mailing Address - Phone:828-287-4840
Mailing Address - Fax:
Practice Address - Street 1:668 POORS FORD RD
Practice Address - Street 2:
Practice Address - City:RUTHERFORDTON
Practice Address - State:NC
Practice Address - Zip Code:28139-4160
Practice Address - Country:US
Practice Address - Phone:828-287-4840
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC28150207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89014YEMedicaid
NCC83170Medicare UPIN
NC2327150Medicare ID - Type Unspecified