Healthcare Provider Details

I. General information

NPI: 1356323208
Provider Name (Legal Business Name): CASTLEMAN EMERGENCY CENTER PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/16/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14050 DIX TOLEDO RD
SOUTHGATE MI
48195-2501
US

IV. Provider business mailing address

14050 DIX TOLEDO RD
SOUTHGATE MI
48195-2501
US

V. Phone/Fax

Practice location:
  • Phone: 734-283-0500
  • Fax: 734-283-2720
Mailing address:
  • Phone: 734-283-0500
  • Fax: 734-283-2720

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: LAWRENCE D CASTLEMAN
Title or Position: PRESIDENT
Credential: MD
Phone: 734-283-0500