Provider Demographics
NPI:1811330996
Name:CASSCELLS, NICHOLAS DYSON
Entity type:Individual
Prefix:
First Name:NICHOLAS
Middle Name:DYSON
Last Name:CASSCELLS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 418283
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02241-8283
Mailing Address - Country:US
Mailing Address - Phone:703-558-1400
Mailing Address - Fax:703-558-1445
Practice Address - Street 1:3800 RESERVOIR RD NW
Practice Address - Street 2:DEPT OF ORTHOPAEDIC SURGERY
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20007-2113
Practice Address - Country:US
Practice Address - Phone:202-444-8766
Practice Address - Fax:202-444-0272
Is Sole Proprietor?:No
Enumeration Date:2013-04-09
Last Update Date:2023-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD047193207XX0004X, 207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XX0004XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryFoot and Ankle Surgery