Provider Demographics
NPI:1356323208
Name:CASTLEMAN EMERGENCY CENTER PC
Entity Type:Organization
Organization Name:CASTLEMAN EMERGENCY CENTER PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:D
Authorized Official - Last Name:CASTLEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:734-283-0500
Mailing Address - Street 1:14050 DIX TOLEDO RD
Mailing Address - Street 2:
Mailing Address - City:SOUTHGATE
Mailing Address - State:MI
Mailing Address - Zip Code:48195-2501
Mailing Address - Country:US
Mailing Address - Phone:734-283-0500
Mailing Address - Fax:734-283-2720
Practice Address - Street 1:14050 DIX TOLEDO RD
Practice Address - Street 2:
Practice Address - City:SOUTHGATE
Practice Address - State:MI
Practice Address - Zip Code:48195-2501
Practice Address - Country:US
Practice Address - Phone:734-283-0500
Practice Address - Fax:734-283-2720
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI3398300Medicaid
40370OtherBCBS
40370OtherBCBS