Provider Demographics
NPI:1245285436
Name:CASTELLANI, SAM U (MD)
Entity type:Individual
Prefix:DR
First Name:SAM
Middle Name:U
Last Name:CASTELLANI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:500 LENTZ DR
Mailing Address - Street 2:SUITE 90 B
Mailing Address - City:MADISON
Mailing Address - State:TN
Mailing Address - Zip Code:37115-5135
Mailing Address - Country:US
Mailing Address - Phone:615-868-6336
Mailing Address - Fax:615-868-6052
Practice Address - Street 1:500 LENTZ DR
Practice Address - Street 2:SUITE 90 B
Practice Address - City:MADISON
Practice Address - State:TN
Practice Address - Zip Code:37115-5135
Practice Address - Country:US
Practice Address - Phone:615-868-6336
Practice Address - Fax:615-868-6052
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-24
Last Update Date:2008-12-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TNMD19715173000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes173000000XOther Service ProvidersLegal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN30450111Medicaid
TNA15127Medicare UPIN
TN30450111Medicare PIN