Provider Demographics
NPI:1184426215
Name:CASTILOW, EMMA KAYE (DMS, PA-C)
Entity type:Individual
Prefix:
First Name:EMMA
Middle Name:KAYE
Last Name:CASTILOW
Suffix:
Gender:
Credentials:DMS, PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 STILLHOUSE PL
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27704-1489
Mailing Address - Country:US
Mailing Address - Phone:304-312-5220
Mailing Address - Fax:
Practice Address - Street 1:5107 SOUTHPARK DR STE 104
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27713-8400
Practice Address - Country:US
Practice Address - Phone:919-477-6900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-27
Last Update Date:2025-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-15261363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant