Provider Demographics
NPI:1770663866
Name:STEPHEN P CASSIS MD
Entity Type:Organization
Organization Name:STEPHEN P CASSIS MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MELISA
Authorized Official - Middle Name:
Authorized Official - Last Name:CASSIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-925-3937
Mailing Address - Street 1:301 49TH ST SE STE A
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25304-1909
Mailing Address - Country:US
Mailing Address - Phone:304-925-3937
Mailing Address - Fax:304-925-4336
Practice Address - Street 1:301 49TH ST SE STE A
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25304-1909
Practice Address - Country:US
Practice Address - Phone:304-925-3937
Practice Address - Fax:304-925-4336
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-16
Last Update Date:2016-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV2026-IOD1152W00000X
WV12950207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
No152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty