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NPI Code Detail

MEDICARE: JONATHAN AARON DUCASTEL MD

MEDICARE: JONATHAN AARON DUCASTEL MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RN0300XNephrology Physician4301112263MI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1073956694
Entity Type Code : Individual
Provider Name (Legal Business Name) : JONATHAN AARON DUCASTEL MD
Provider Business Mailing Address
First Line : 3537 W FRONT ST STE A
Second Line :
City : TRAVERSE CITY
State : MI
Zip : 49684-7942
Country : US
Telephone Number : 231-935-0338
Fax Number : 231-258-7555
Provider Business Practice Location Address
First Line : 3537 W FRONT ST STE A
Second Line :
City : TRAVERSE CITY
State : MI
Zip : 49684-7942
Country : US
Telephone Number : 231-935-0338
Fax Number : 231-258-7555
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/12/2013
Last Update Date : 08/05/2025

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Directions to “ JONATHAN AARON DUCASTEL MD” Practice Location

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