Cassidy, Colleen F
Cassidy, Colleen F is an individual health care provider with primary practice located at 130 Corporate Dr , Beaver Dam WI 53916-3116. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Cassidy, Colleen F can be contacted via phone (920) 887-3102.Contact Information
Primary practice address
130 Corporate Dr
Beaver Dam WI 53916-3116
Phone: (920) 887-3102
Fax: (920) 855-8790
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 61855-20 | Wisconsin |
Profile Details
| NPI number | 1275899841 |
|---|---|
| LBN Legal business name | Cassidy, Colleen F |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 7th, 2012 |
| Last updated | Mar 1st, 2021 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1275899841 | NPPES |
| Wisconsin | MEDICAID | 1275899841 |
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