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General NPI Number Information
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NPI Number | 1306950100
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Entity Type | Individual
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Provider Name | MARIA C CASTELLANO M.D.
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Gender | Female
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Dates
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Enumeration Date | 08/18/2006
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Last Update Date | 02/03/2011
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Provider Practice Location Address
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Address Line | 2418 N OAK ST SUITE G
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City | VALDOSTA
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State | GA
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Zip | 31602-2576
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Country | US
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Telephone | 229-588-4688
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Fax | 229-588-4468
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Provider Business Mailing Address
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Address Line | 2418 N OAK ST SUITE G
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City | VALDOSTA
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State | GA
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Zip | 31602-2576
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Country | US
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Telephone | 229-588-4688
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Fax | 229-588-4468
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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 | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 045419
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License Number State | GA
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