Healthcare Provider Details

I. General information

NPI: 1528054939
Provider Name (Legal Business Name): DAVID M CASTELLAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2005
Last Update Date: 08/19/2020
Certification Date: 08/19/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 MEDICAL PARK DR
LEWISBURG PA
17837-6343
US

IV. Provider business mailing address

100 N ACADEMY AVE
DANVILLE PA
17822-4903
US

V. Phone/Fax

Practice location:
  • Phone: 570-523-3264
  • Fax: 570-523-3465
Mailing address:
  • Phone: 570-271-6144
  • Fax: 570-271-6578

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD068484L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: