Provider Demographics
NPI:1063496792
Name:CASTELLINO, SHARON (MD, MSC)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:
Last Name:CASTELLINO
Suffix:
Gender:F
Credentials:MD, MSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5461 MERIDIAN MARK RD STE 400
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30342-3283
Mailing Address - Country:US
Mailing Address - Phone:404-785-1112
Mailing Address - Fax:404-785-3600
Practice Address - Street 1:5461 MERIDIAN MARK RD STE 400
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-3283
Practice Address - Country:US
Practice Address - Phone:404-785-1112
Practice Address - Fax:404-785-3600
Is Sole Proprietor?:No
Enumeration Date:2005-12-06
Last Update Date:2022-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA746732080P0207X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0207XAllopathic & Osteopathic PhysiciansPediatricsPediatric Hematology-Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC891379GMedicaid
804975OtherPARTNERS
D8025OtherMEDCOST
D8025OtherMEDCOST