Provider Demographics
NPI:1457301293
Name:CASTRO, DAN J (MD)
Entity Type:Individual
Prefix:DR
First Name:DAN
Middle Name:J
Last Name:CASTRO
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3238 CAPITAL AVE SW
Mailing Address - Street 2:
Mailing Address - City:BATTLE CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:49015-4302
Mailing Address - Country:US
Mailing Address - Phone:269-245-8590
Mailing Address - Fax:269-245-8591
Practice Address - Street 1:3238 CAPITAL AVE SW
Practice Address - Street 2:
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49015-4302
Practice Address - Country:US
Practice Address - Phone:269-245-8590
Practice Address - Fax:269-245-8591
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2015-03-31
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI4301097744207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0130395OtherBCBSM
OKA85409Medicare UPIN
MI1457301293Medicare PIN