Provider Demographics
NPI:1184318859
Name:CASTRO, ELVIS ARTURO (MD)
Entity type:Individual
Prefix:
First Name:ELVIS
Middle Name:ARTURO
Last Name:CASTRO
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 1:718 ONTARIO ST APT 1
Mailing Address - Street 2:
Mailing Address - City:STORM LAKE
Mailing Address - State:IA
Mailing Address - Zip Code:50588-1872
Mailing Address - Country:US
Mailing Address - Phone:712-730-3791
Mailing Address - Fax:
Practice Address - Street 1:1415 WOODLAND AVE STE 140
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50309-3203
Practice Address - Country:US
Practice Address - Phone:515-241-4076
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-06
Last Update Date:2023-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAR-12717208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery