Provider Demographics
NPI:1588757371
Name:CASSIDY, MICHAEL P (MD)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:P
Last Name:CASSIDY
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Gender:M
Credentials:MD
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Mailing Address - Street 1:3301 WOODBURN RD #208
Mailing Address - Street 2:
Mailing Address - City:ANNANDALE
Mailing Address - State:VA
Mailing Address - Zip Code:22003-1200
Mailing Address - Country:US
Mailing Address - Phone:703-560-9495
Mailing Address - Fax:903-698-7237
Practice Address - Street 1:3301 WOODBURN RD #208
Practice Address - Street 2:
Practice Address - City:ANNANDALE
Practice Address - State:VA
Practice Address - Zip Code:22003-1200
Practice Address - Country:US
Practice Address - Phone:703-560-9495
Practice Address - Fax:903-698-7237
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2010-07-15
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Provider Licenses
StateLicense IDTaxonomies
VA0101036477207XS0114X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0114XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryAdult Reconstructive Orthopaedic Surgery