Provider Demographics
NPI:1508856568
Name:CASTROP, JULIE ANNE (MD)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:ANNE
Last Name:CASTROP
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:555 S 18TH ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43205-2654
Mailing Address - Country:US
Mailing Address - Phone:614-722-4950
Mailing Address - Fax:614-722-4966
Practice Address - Street 1:555 S 18TH ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43205-2654
Practice Address - Country:US
Practice Address - Phone:614-722-4950
Practice Address - Fax:614-722-4966
Is Sole Proprietor?:No
Enumeration Date:2005-10-21
Last Update Date:2008-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35062772208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0107695000Medicaid
KY64869548Medicaid
OH0869645Medicaid
KY64869548Medicaid
F51775Medicare UPIN