Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207QA0505X | Family Doctor - Adult Medicine | 00024406 | AL |
NPI | 1023093556 |
---|---|
Provider Name | Dr. Anthony Castillo Biascan |
First Address | Fpo, AE 09636-0010 |
Second Address | Fpo, AE 09636-0010 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/12/2005 |
Last Update Date | 03/12/2015 |