Provider Demographics
NPI:1932183589
Name:CASEY, SEAN OWEN (MD)
Entity Type:Individual
Prefix:DR
First Name:SEAN
Middle Name:OWEN
Last Name:CASEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:11995 SINGLETREE LN
Mailing Address - Street 2:SUITE 500
Mailing Address - City:EDEN PRAIRIE
Mailing Address - State:MN
Mailing Address - Zip Code:55344-5347
Mailing Address - Country:US
Mailing Address - Phone:952-595-1242
Mailing Address - Fax:952-942-3361
Practice Address - Street 1:6292 CHASEWOOD DR
Practice Address - Street 2:
Practice Address - City:EDEN PRAIRIE
Practice Address - State:MN
Practice Address - Zip Code:55344-3289
Practice Address - Country:US
Practice Address - Phone:952-595-1242
Practice Address - Fax:952-942-3361
Is Sole Proprietor?:No
Enumeration Date:2005-12-06
Last Update Date:2009-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN399412085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
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MN251225400Medicaid
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G54324Medicare UPIN
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