Provider Demographics
NPI:1710965017
Name:CASSEL, CHARLES T (MD)
Entity Type:Individual
Prefix:
First Name:CHARLES
Middle Name:T
Last Name:CASSEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2300 53RD AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BETTENDORF
Mailing Address - State:IA
Mailing Address - Zip Code:52722-7564
Mailing Address - Country:US
Mailing Address - Phone:563-322-0971
Mailing Address - Fax:563-324-0615
Practice Address - Street 1:2300 53RD AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:BETTENDORF
Practice Address - State:IA
Practice Address - Zip Code:52722-7564
Practice Address - Country:US
Practice Address - Phone:563-322-0971
Practice Address - Fax:563-324-0615
Is Sole Proprietor?:No
Enumeration Date:2006-01-06
Last Update Date:2011-03-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IA22728207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
19797OtherIA HEALTH SOLUTIONS
IA58095OtherWELLMARK
1602919OtherFIRST HEALTH
IL8121085OtherBCBS
IA0038505Medicaid
18577OtherMIDLANDS CHOICE
200029105OtherRR MEDICARE
IAIA0143OtherJOHN DEERE FAMILY
IAT80726OtherJOHN DEERE FAMILY
041067OtherHEALTH ALLIANCE
IA57862OtherWELLMARK
IAT80726OtherJOHN DEERE FAMILY
IA58095OtherWELLMARK