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NPI Code Detail

MEDICARE: DR. DAN J CASTRO MD

MEDICARE: DR. DAN J CASTRO 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
1207Y00000XOtolaryngology Physician4301097744MI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10130395OTHERMIBCBSM

General Provider Information

NPI Number : 1457301293
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DAN J CASTRO MD
Provider Business Mailing Address
First Line : 3238 CAPITAL AVE SW
Second Line :
City : BATTLE CREEK
State : MI
Zip : 49015-4302
Country : US
Telephone Number : 269-245-8590
Fax Number : 269-245-8591
Provider Business Practice Location Address
First Line : 3238 CAPITAL AVE SW
Second Line :
City : BATTLE CREEK
State : MI
Zip : 49015-4302
Country : US
Telephone Number : 269-245-8590
Fax Number : 269-245-8591
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/11/2006
Last Update Date : 03/31/2015

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