Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | MT189539 | PA |
Y | 208600000X | Surgeon | MT189539 | PA |
N | 2086S0102X | Surgical Critical Care | MT 189539 | PA |
NPI | 1124219381 |
---|---|
Provider Name | Jorge Humberto Castro |
First Address | Pittsburgh, PA 15241-1357 |
Second Address | Philadelphia, PA 19124-3508 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/08/2007 |
Last Update Date | 06/07/2019 |