Provider Demographics
NPI:1376835868
Name:CASTERLINE, PETER FREDERICK (MD)
Entity Type:Individual
Prefix:DR
First Name:PETER
Middle Name:FREDERICK
Last Name:CASTERLINE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 OLD WELL LANE
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:PA
Mailing Address - Zip Code:18612
Mailing Address - Country:US
Mailing Address - Phone:570-881-4879
Mailing Address - Fax:
Practice Address - Street 1:5 OLD WELL LANE
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:PA
Practice Address - Zip Code:18612
Practice Address - Country:US
Practice Address - Phone:570-881-4879
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-03
Last Update Date:2011-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD018853E208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery