Provider Demographics
NPI:1639166960
Name:CASCIELLO, MICHAEL CARLYLE (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:CARLYLE
Last Name:CASCIELLO
Suffix:
Gender:M
Credentials:MD
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 12248
Mailing Address - Street 2:
Mailing Address - City:NEW BERN
Mailing Address - State:NC
Mailing Address - Zip Code:28561-2248
Mailing Address - Country:US
Mailing Address - Phone:252-633-5333
Mailing Address - Fax:252-633-9443
Practice Address - Street 1:941 NEWMAN RD
Practice Address - Street 2:
Practice Address - City:NEW BERN
Practice Address - State:NC
Practice Address - Zip Code:28562-5252
Practice Address - Country:US
Practice Address - Phone:252-634-3278
Practice Address - Fax:252-633-3312
Is Sole Proprietor?:No
Enumeration Date:2005-10-03
Last Update Date:2014-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101058326207RC0000X
NC2013-00785207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAPAROtherTRICARE
VAPAROtherBCBS
VAPAROtherMEDCOST
VAPAROtherUNITED HEALTHCARE
VA1639166960Medicaid
VAPAROtherCIGNA
VAPAROtherOPTIMA
VAVAA100859Medicare PIN
VA1639166960Medicaid
VAPAROtherBCBS