Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2080P0207X | Pediatric Hematology-Oncologist | 2011-01872 | NC |
N | 2080P0207X | Pediatric Hematology-Oncologist | 30557 | TN |
NPI | 1255334371 |
---|---|
Provider Name | Dr. Michael B Kastan |
First Address | Charlotte, NC 28263-3362 |
Second Address | Durham, NC 27705-3941 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2005 |
Last Update Date | 30/01/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00119795 | (05) | MS |
009913800 | (05) | AL |
010056187 | (05) | VA |
0527887 | (05) | IA |
060489401 | (05) | TX |
100034850A | (05) | OK |
1135066 00 | (05) | WY |
1555533 | (05) | LA |
200190170A | (05) | IN |
2064582 | (05) | OH |
3827798 | (05) | TN |
422400000 | (05) | ME |
64929516 | (05) | KY |
D95953 | (02) | TN |