Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | 53909 | TN |
N | 208800000X | Urologist | 82404 | SC |
NPI | 1063702538 |
---|---|
Provider Name | Dr. Scott M Castle |
First Address | Atlanta, GA 30374-3904 |
Second Address | Columbia, SC 29201-2946 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/04/2011 |
Last Update Date | 09/09/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
824040 | (05) | SC |