1588853279 NPI number — NATHAN CASTLEMAN, D.P.M.

Table of content: (NPI 1588853279)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1588853279 NPI number — NATHAN CASTLEMAN, D.P.M.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NATHAN CASTLEMAN, D.P.M.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1588853279
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/18/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1223E NATIONAL HWY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LAVALE
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21502-7602
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
301-729-1838
Provider Business Mailing Address Fax Number:
301-729-1839

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1223E NATIONAL HWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LAVALE
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21502-7602
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-729-1838
Provider Business Practice Location Address Fax Number:
301-729-1839
Provider Enumeration Date:
10/18/2007

Additional Information

Authorized Official

Authorized Official Last Name:
GRAPES
Authorized Official First Name:
MELISSA
Authorized Official Middle Name:
Authorized Official Title or Position:
OFFICE MANAGER
Authorized Official Telephone Number:
301-722-7970

Provider Taxonomy Codes

  • Taxonomy code: 213ES0103X , with the licence number:  00548 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: R2280001 . This is a "CAREFIRST NCA" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 218820 . This is a "MAMSI" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 0100210000 , issued by the state of ( WV ) . This identifiers is of the category "MEDICAID".
  • Identifier: T196N . This is a "CAREFIRST" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com