Provider Demographics
NPI:1073735684
Name:MARSHALL, ELIZABETH CASTILLO (MD)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:CASTILLO
Last Name:MARSHALL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1701 TWIN SPRINGS RD FL 3
Mailing Address - Street 2:
Mailing Address - City:HALETHORPE
Mailing Address - State:MD
Mailing Address - Zip Code:21227-3553
Mailing Address - Country:US
Mailing Address - Phone:410-737-5300
Mailing Address - Fax:410-737-5301
Practice Address - Street 1:1701 TWIN SPRINGS RD FL 3
Practice Address - Street 2:
Practice Address - City:HALETHORPE
Practice Address - State:MD
Practice Address - Zip Code:21227-3553
Practice Address - Country:US
Practice Address - Phone:410-737-5300
Practice Address - Fax:410-737-5301
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-03
Last Update Date:2021-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2006-019482086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC039886400Medicaid
MD406964101Medicaid
129350YT2Medicare UPIN