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General NPI Number Information
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NPI Number | 1437535705
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Entity Type | Individual
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Provider Name | DR ELIZABETH ELIZA CASTLE BBA,MED,PCS
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Gender | Female
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Dates
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Enumeration Date | 08/10/2015
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Last Update Date | 08/10/2015
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Provider Practice Location Address
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Address Line | 1527 SAM RITTENBERG BLVD STE 202
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City | CHARLESTON
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State | SC
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Zip | 29407-4189
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Country | US
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Telephone | 404-935-8722
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Fax |
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Provider Business Mailing Address
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Address Line | 1643 B SAVANNAH HIGHWAY STE 351
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City | CHARLESTON
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State | SC
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Zip | 29407
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Country | US
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Telephone | 404-935-8722
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 081515-1
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License Number State | GA
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