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General NPI Number Information
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NPI Number | 1124369038
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Entity Type | Individual
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Provider Name | SUZANNE FARHANG CASTNER PA-C
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Gender | Female
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Dates
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Enumeration Date | 03/04/2013
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Last Update Date | 08/19/2016
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Provider Practice Location Address
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Address Line | 10910 LITTLE PATUXENT PKWY 200
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City | COLUMBIA
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State | MD
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Zip | 21044-3078
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Country | US
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Telephone | 410-997-2770
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Fax |
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Provider Business Mailing Address
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Address Line | 1235 E MONUMENT ST
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City | BALTIMORE
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State | MD
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Zip | 21202-5327
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Country | US
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Telephone | 410-327-5100
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | C0004999
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License Number State | MD
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