Provider Demographics
NPI:1649750951
Name:CASTRO MEDINA, MARIO (MD)
Entity Type:Individual
Prefix:DR
First Name:MARIO
Middle Name:
Last Name:CASTRO MEDINA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:MARIO
Other - Middle Name:
Other - Last Name:CASTRO-MEDINA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:UPMC CHILDRENS HOSPITAL OF PITTSBURGH
Mailing Address - Street 2:4401 PENN AVENUE FACULTY PAVILLION 5TH FLOOR
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15224
Mailing Address - Country:US
Mailing Address - Phone:412-692-5218
Mailing Address - Fax:412-692-5817
Practice Address - Street 1:UPMC CHILDRENS HOSPITAL OF PITTSBURGH
Practice Address - Street 2:4401 PENN AVENUE FACULTY PAVILLION 5TH FLOOR
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15224
Practice Address - Country:US
Practice Address - Phone:412-692-5218
Practice Address - Fax:412-692-5817
Is Sole Proprietor?:No
Enumeration Date:2018-08-16
Last Update Date:2018-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD465293204F00000X, 208600000X, 208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
No204F00000XAllopathic & Osteopathic PhysiciansTransplant Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery