Provider Demographics
NPI:1568482172
Name:CASSIMATIS, EMMANUEL GEORGE (MD)
Entity Type:Individual
Prefix:DR
First Name:EMMANUEL
Middle Name:GEORGE
Last Name:CASSIMATIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:NICHOLAS EMMANUEL
Other - Middle Name:GEORGE
Other - Last Name:CASSIMATIS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:9619 KINGSTON RD
Mailing Address - Street 2:
Mailing Address - City:KENSINGTON
Mailing Address - State:MD
Mailing Address - Zip Code:20895-3521
Mailing Address - Country:US
Mailing Address - Phone:301-949-8707
Mailing Address - Fax:
Practice Address - Street 1:4301 JONES BRIDGE RD
Practice Address - Street 2:RM A1008, USUHS
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814-4799
Practice Address - Country:US
Practice Address - Phone:301-295-1917
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD00220382084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry