Provider Demographics
NPI:1881645505
Name:BIERRENBACH DECASTRO, RICARDO C (MD)
Entity Type:Individual
Prefix:DR
First Name:RICARDO
Middle Name:C
Last Name:BIERRENBACH DECASTRO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:RICARDO
Other - Middle Name:C
Other - Last Name:BIERRENBACH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:1979 HENDERSONVILLE RD STE D
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28803-2475
Mailing Address - Country:US
Mailing Address - Phone:828-974-7004
Mailing Address - Fax:
Practice Address - Street 1:1979 HENDERSONVILLE RD STE D
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28803-2475
Practice Address - Country:US
Practice Address - Phone:828-974-7004
Practice Address - Fax:828-974-7005
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-15
Last Update Date:2019-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2002008662084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89132CHMedicaid
NCH74266Medicare UPIN
NC2008334AMedicare ID - Type Unspecified