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NPI Code Detail

MEDICARE: DAVID LOUIS CASTELLONE MD

MEDICARE: DAVID LOUIS CASTELLONE 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
1207Q00000XFamily Medicine Physician11567SC

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1080090612OTHERSCRR MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1356308654
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAVID LOUIS CASTELLONE MD
Provider Business Mailing Address
First Line : PO BOX 530062
Second Line :
City : ATLANTA
State : GA
Zip : 30353-0062
Country : US
Telephone Number : 843-695-6071
Fax Number : 843-569-5879
Provider Business Practice Location Address
First Line : 213 W 4TH NORTH ST
Second Line :
City : SUMMERVILLE
State : SC
Zip : 29483-6541
Country : US
Telephone Number : 843-873-0681
Fax Number : 843-873-2749
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/28/2006
Last Update Date : 07/06/2021

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Directions to “ DAVID LOUIS CASTELLONE MD” Practice Location

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