Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0122X | Plastic and Reconstructive Surgery | 2006-01948 | NC |
NPI | 1073735684 |
---|---|
Provider Name | Dr. Elizabeth Castillo Marshall |
First Address | Halethorpe, MD 21227-3553 |
Second Address | Halethorpe, MD 21227-3553 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/05/2007 |
Last Update Date | 20/07/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
039886400 | (05) | DC |
129350YT2 | (02) | |
406964101 | (05) | MD |