| Doctor Name: | CASSANDRA WORMACK |
| NPI Number: | 1023217437 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MD |
| License Number: | 4301072467 |
| Business Practice Address: | 4444 W Bristol Rd Ste. 150 Flint, MI - 485073153 |
| Business Phone Number: | 8102309500 |
| Business Fax Number: | 8102300169 |
| Mailing Address: | Po Box 1239, TROY |
| State: | MI |
| Postal Code: | 480991239 |
| Phone Number: | 2488246600 |
| Fax Number: | 8556186655 |
| NPI Enumeration Date: | 07/16/2007 |
| NPI Last Update Date: | 07/10/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 4301072467 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MI |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |