Healthcare Provider Details

I. General information

NPI: 1740507797
Provider Name (Legal Business Name): DARWIN-DEAN TABIOS CASTILLO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/30/2010
Last Update Date: 03/10/2025
Certification Date: 03/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4374 NEW TOWN AVE STE 100
WILLIAMSBURG VA
23188-2865
US

IV. Provider business mailing address

44045 RIVERSIDE PKWY
LEESBURG VA
20176-5101
US

V. Phone/Fax

Practice location:
  • Phone: 757-772-6124
  • Fax:
Mailing address:
  • Phone: 703-858-6044
  • Fax: 703-858-6775

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number30537
License Number StateWV
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number0101254805
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: