Provider Demographics
NPI:1588853279
Name:NATHAN CASTLEMAN, D.P.M.
Entity Type:Organization
Organization Name:NATHAN CASTLEMAN, D.P.M.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:GRAPES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-722-7970
Mailing Address - Street 1:1223E NATIONAL HWY
Mailing Address - Street 2:
Mailing Address - City:LAVALE
Mailing Address - State:MD
Mailing Address - Zip Code:21502-7602
Mailing Address - Country:US
Mailing Address - Phone:301-729-1838
Mailing Address - Fax:301-729-1839
Practice Address - Street 1:1223E NATIONAL HWY
Practice Address - Street 2:
Practice Address - City:LAVALE
Practice Address - State:MD
Practice Address - Zip Code:21502-7602
Practice Address - Country:US
Practice Address - Phone:301-729-1838
Practice Address - Fax:301-729-1839
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-18
Last Update Date:2007-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD00548213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDR2280001OtherCAREFIRST NCA
MD218820OtherMAMSI
WV0100210000Medicaid
MDT196NOtherCAREFIRST
MDT59857Medicare UPIN
MD218820OtherMAMSI
WV0100210000Medicaid