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NPI Code Detail

MEDICARE: MS. ELAINE DEL CASTILLO MATOS PA

MEDICARE: MS. ELAINE DEL CASTILLO MATOS PA
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
1363A00000XPhysician Assistant0010-05465NC
2363A00000XPhysician Assistant50002385OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1000000388100OTHEROHANTHEM

General Provider Information

NPI Number : 1538116249
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. ELAINE DEL CASTILLO MATOS PA
Provider Business Mailing Address
First Line : 615 SHIPYARD BLVD
Second Line :
City : WILMINGTON
State : NC
Zip : 28412-6431
Country : US
Telephone Number : 910-343-0145
Fax Number : 910-341-5779
Provider Business Practice Location Address
First Line : 1414 MEDICAL CENTER DR
Second Line :
City : WILMINGTON
State : NC
Zip : 28401-7505
Country : US
Telephone Number : 910-790-9949
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/28/2006
Last Update Date : 05/01/2025

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Directions to “ MS. ELAINE DEL CASTILLO MATOS PA” Practice Location

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