Provider Demographics
NPI:1396927604
Name:CASTRUCCI, WILLIAM ARTHUR (MD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:ARTHUR
Last Name:CASTRUCCI
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:PO BOX 683
Mailing Address - Street 2:
Mailing Address - City:WATERVILLE
Mailing Address - State:ME
Mailing Address - Zip Code:04903-0683
Mailing Address - Country:US
Mailing Address - Phone:207-873-6034
Mailing Address - Fax:207-872-9136
Practice Address - Street 1:33 WHITING HILL RD
Practice Address - Street 2:
Practice Address - City:BREWER
Practice Address - State:ME
Practice Address - Zip Code:04412-1021
Practice Address - Country:US
Practice Address - Phone:207-973-7499
Practice Address - Fax:207-973-7630
Is Sole Proprietor?:No
Enumeration Date:2007-11-28
Last Update Date:2023-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME0181682085R0001X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME001336501OtherMEDICARE PTAN
ME434641199Medicaid