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General NPI Number Information
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NPI Number | 1407389844
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Entity Type | Individual
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Provider Name | MICHAEL CASTILLO MD
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Gender | Male
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Dates
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Enumeration Date | 04/04/2017
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Last Update Date | 02/27/2025
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Provider Practice Location Address
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Address Line | 980 JOHNSON FERRY RD STE 820
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City | ATLANTA
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State | GA
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Zip | 30342-1608
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Country | US
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Telephone | 404-252-9307
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Fax | 404-252-5839
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Provider Business Mailing Address
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Address Line | 980 JOHNSON FERRY RD STE 820
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City | ATLANTA
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State | GA
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Zip | 30342-1608
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Country | US
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Telephone | 404-252-9307
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Fax | 404-252-5839
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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 | 322391
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 103068
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License Number State | GA
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