Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208D00000X | General Practice Physician | 0101258724 | VA |
NPI | 1023421377 |
---|---|
Provider Name | Dr. Stephen Dunford Kasteler |
First Address | Jbsa Lackland, TX 78236-5514 |
Second Address | Jbsa Lackland, TX 78236-5514 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/06/2014 |
Last Update Date | 01/09/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
VAD0000 | (02) |