Provider Demographics
NPI:1750311130
Name:CASTRO, BRIGID G (MD)
Entity Type:Individual
Prefix:
First Name:BRIGID
Middle Name:G
Last Name:CASTRO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:BRIGID
Other - Middle Name:A
Other - Last Name:GORDON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2722 MERRILEE DR
Mailing Address - Street 2:STE. 230
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22031-4400
Mailing Address - Country:US
Mailing Address - Phone:703-698-4483
Mailing Address - Fax:703-698-2176
Practice Address - Street 1:2722 MERRILEE DR
Practice Address - Street 2:STE. 230
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031-4400
Practice Address - Country:US
Practice Address - Phone:703-698-4483
Practice Address - Fax:703-573-0880
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2022-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101058648207UN0901X, 207UN0902X, 2085B0100X, 2085N0904X, 2085U0001X, 2085R0202X, 2085P0229X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No207UN0901XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear Cardiology
No207UN0902XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear Imaging & Therapy
No2085B0100XAllopathic & Osteopathic PhysiciansRadiologyBody Imaging
No2085N0904XAllopathic & Osteopathic PhysiciansRadiologyNuclear Radiology
No2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Ultrasound
No2085P0229XAllopathic & Osteopathic PhysiciansRadiologyPediatric Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA7217943Medicaid
WV7200996000Medicaid
VA007217943Medicaid
VA224404OtherANTHEM
MD141200100Medicaid
VA0042OtherCAREFIRST BCBS
VA2123444OtherAETNA HMO
VA5565518OtherAETNA PPO
VA2123444OtherAETNA HMO
VA007217943Medicaid
DC001961F43Medicare PIN
MD141200100Medicaid
VAP00329394Medicare PIN