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NPI Code Detail

MEDICARE: DR. DAVID KEVIN CASSIDY MD

MEDICARE: DR. DAVID KEVIN CASSIDY MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine PhysicianMD00026401WA

General Provider Information

NPI Number : 1417975988
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DAVID KEVIN CASSIDY MD
Provider Business Mailing Address
First Line : 690 BARNES BLVD
Second Line :
City : JOINT BASE LEWIS MCCHORD
State : WA
Zip : 98438-1303
Country : US
Telephone Number : 253-982-5601
Fax Number :
Provider Business Practice Location Address
First Line : 690 BARNES BLVD
Second Line :
City : JOINT BASE LEWIS MCCHORD
State : WA
Zip : 98438-1303
Country : US
Telephone Number : 253-982-5601
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/17/2006
Last Update Date : 02/19/2016

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Directions to “ DR. DAVID KEVIN CASSIDY MD” Practice Location

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