Provider Demographics
NPI:1801886155
Name:CASCIO, RICHARD A (MD)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:A
Last Name:CASCIO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:28963 LITTLE MACK
Mailing Address - Street 2:STE 101
Mailing Address - City:ST CLAIR SHORES
Mailing Address - State:MI
Mailing Address - Zip Code:48081
Mailing Address - Country:US
Mailing Address - Phone:586-447-0700
Mailing Address - Fax:586-498-0707
Practice Address - Street 1:28963 LITTLE MACK
Practice Address - Street 2:STE 101
Practice Address - City:ST CLAIR SHORES
Practice Address - State:MI
Practice Address - Zip Code:48081
Practice Address - Country:US
Practice Address - Phone:586-447-0700
Practice Address - Fax:586-498-0707
Is Sole Proprietor?:No
Enumeration Date:2005-10-27
Last Update Date:2010-06-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301055258207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
0570850001OtherCIGNA
MI304473310Medicaid
5962202OtherAETNA
P84580OtherBCN
0570850001OtherCIGNA
5962202OtherAETNA