Provider Demographics
NPI:1902862279
Name:CASADAY, FLOYD M III (MD)
Entity Type:Individual
Prefix:
First Name:FLOYD
Middle Name:M
Last Name:CASADAY
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1265 WAYNE AVE
Mailing Address - Street 2:SUITE 306 119 PROFESSIONAL CENTER
Mailing Address - City:INDIANA
Mailing Address - State:PA
Mailing Address - Zip Code:15701
Mailing Address - Country:US
Mailing Address - Phone:724-349-3233
Mailing Address - Fax:724-349-2339
Practice Address - Street 1:1265 WAYNE AVE
Practice Address - Street 2:SUITE 306 119 PROFESSIONAL CENTER
Practice Address - City:INDIANA
Practice Address - State:PA
Practice Address - Zip Code:15701
Practice Address - Country:US
Practice Address - Phone:724-349-3233
Practice Address - Fax:724-349-2339
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-25
Last Update Date:2008-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD016283E207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA000949889Medicaid
PACA132329Medicare PIN
PAC31185Medicare UPIN