MEDICARE: CHRISTIAN EBER CASTILLO 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
1	207R00000X	Internal Medicine Physician	MT186475	PA
2	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	A125486	CA
3	207RP1001X	Pulmonary Disease Physician	A125486	CA
4	207R00000X	Internal Medicine Physician	37392	SC
5	207RS0012X	Sleep Medicine (Internal Medicine) Physician	A125486	CA
6	207RP1001X	Pulmonary Disease Physician	37392	SC

Other Identifiers

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

General Provider Information

NPI Number	:	1316000979
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTIAN EBER CASTILLO MD

Provider Business Mailing Address
First Line	:	151 HAROLD FLEMING CT
Second Line	:
City	:	SPARTANBURG
State	:	SC
Zip	:	29303-4225
Country	:	US
Telephone Number	:	864-573-6320
Fax Number	:	864-208-0352

Provider Business Practice Location Address
First Line	:	151 HAROLD FLEMING CT
Second Line	:
City	:	SPARTANBURG
State	:	SC
Zip	:	29303-4225
Country	:	US
Telephone Number	:	864-573-6320
Fax Number	:	864-208-0352

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/18/2006
Last Update Date	:	12/17/2021

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