Provider Demographics
NPI:1487178083
Name:DE CASTRO, MARIA LOURDES MORALES
Entity Type:Individual
Prefix:DR
First Name:MARIA LOURDES
Middle Name:MORALES
Last Name:DE CASTRO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9111 ANTIQUE ALY UNIT 1
Mailing Address - Street 2:
Mailing Address - City:BRIDGEVILLE
Mailing Address - State:DE
Mailing Address - Zip Code:19933-4682
Mailing Address - Country:US
Mailing Address - Phone:302-337-9320
Mailing Address - Fax:
Practice Address - Street 1:9111 ANTIQUE ALY UNIT 1
Practice Address - Street 2:
Practice Address - City:BRIDGEVILLE
Practice Address - State:DE
Practice Address - Zip Code:19933-4682
Practice Address - Country:US
Practice Address - Phone:302-337-9320
Practice Address - Fax:302-337-7351
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-26
Last Update Date:2021-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC1-0013552207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine