Healthcare Provider Details

I. General information

NPI: 1912970955
Provider Name (Legal Business Name): DAVID JAMES CASTALDO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/09/2006
Last Update Date: 12/02/2020
Certification Date: 12/02/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

648 GRASSFIELD PKWY STE 1
CHESAPEAKE VA
23322-7465
US

IV. Provider business mailing address

PO BOX 11314
BELFAST ME
04915-4004
US

V. Phone/Fax

Practice location:
  • Phone: 757-312-6797
  • Fax: 757-410-0390
Mailing address:
  • Phone: 757-842-4481
  • Fax: 757-312-3135

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number0101054197
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: