Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204F00000X | Transplant Surgeon | MD465293 | PA |
N | 208200000X | Surgeon | MD465293 | PA |
N | 208600000X | Surgeon | MD465293 | PA |
Y | 208G00000X | Cardiothoracic Vascular Surgeon | MD465293 | PA |
NPI | 1649750951 |
---|---|
Provider Name | Dr. Mario Castro Medina |
First Address | Pittsburgh, PA 15224 |
Second Address | Pittsburgh, PA 15224 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/08/2018 |
Last Update Date | 20/11/2018 |