1932108503 NPI number — EDWIN E KASHA M.D.

Table of content: EDWIN E KASHA M.D. (NPI 1932108503)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1932108503 NPI number — EDWIN E KASHA M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KASHA
Provider First Name:
EDWIN
Provider Middle Name:
E
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1932108503
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/09/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 15415
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
EVANSVILLE
Provider Business Mailing Address State Name:
IN
Provider Business Mailing Address Postal Code:
47716-0415
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
812-477-9495
Provider Business Mailing Address Fax Number:
812-477-0134

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
999 S KENMORE DR
Provider Second Line Business Practice Location Address:
SUITE A
Provider Business Practice Location Address City Name:
EVANSVILLE
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
47714-7514
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
812-477-9495
Provider Business Practice Location Address Fax Number:
812-477-0134
Provider Enumeration Date:
07/18/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207N00000X , with the licence number:  01032814 , registered in the state of IN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 000000108102 . This is a "ANTHEM PREFERRED ACCESS" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 000000526765 . This is a "ANTHEM" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".
  • Identifier: 020007857 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".
  • Identifier: 35-1738788 . This is a "FEDERAL TAX ID" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".




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