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NPI Code Detail

MEDICARE: DR. CANDICE NADIA CASTELLINO MD

MEDICARE: DR. CANDICE NADIA CASTELLINO MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208000000XPediatrics Physician2019-02745NC

General Provider Information

NPI Number : 1134564883
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CANDICE NADIA CASTELLINO MD
Provider Business Mailing Address
First Line : PO BOX 60447
Second Line :
City : CHARLOTTE
State : NC
Zip : 28260-0447
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 8110 HEALTHCARE LOOP
Second Line :
City : CHARLOTTE
State : NC
Zip : 28215-7069
Country : US
Telephone Number : 704-316-2312
Fax Number : 704-316-2316
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/08/2013
Last Update Date : 10/26/2020

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