Healthcare Provider Details
I. General information
NPI: 1578580411
Provider Name (Legal Business Name): FERNANDO CASTRO-URRUTIA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/16/2006
Last Update Date: 11/16/2025
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
259 E CHICAGO ST
COLDWATER MI
49036-2046
US
IV. Provider business mailing address
1131 N OSSEO RD
HILLSDALE MI
49242-9714
US
V. Phone/Fax
- Phone: 517-278-9812
- Fax:
- Phone: 517-523-3695
- Fax: 517-523-3311
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2084P0805X |
| Taxonomy | Geriatric Psychiatry Physician |
| License Number | FC067134 |
| License Number State | MI |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: