Provider Demographics
NPI:1588669139
Name:CASTALDO, WILLIAM A (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:A
Last Name:CASTALDO
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:PO BOX 1013
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:OH
Mailing Address - Zip Code:45373-8013
Mailing Address - Country:US
Mailing Address - Phone:937-335-9998
Mailing Address - Fax:937-335-9840
Practice Address - Street 1:3006 N COUNTY ROAD 25A
Practice Address - Street 2:STE 102
Practice Address - City:TROY
Practice Address - State:OH
Practice Address - Zip Code:45373-1373
Practice Address - Country:US
Practice Address - Phone:937-335-2075
Practice Address - Fax:937-339-0612
Is Sole Proprietor?:No
Enumeration Date:2005-06-20
Last Update Date:2013-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35064655207RP1001X, 207RC0200X, 207RS0012X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0918181Medicaid
OH0739567Medicare ID - Type Unspecified
OH0918181Medicaid