Individual
FERNANDO RAUL DOMINGO DE CASTRO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4150 N 108TH AVE, STE 142, PHOENIX, AZ 85037-5467
(623) 322-1145
(623) 466-9552
Mailing address
9524 W CAMELBACK RD PMB 186, STE 130, GLENDALE, AZ 85305-0901
(623) 322-1145
(623) 466-9552
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
30062
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64873504
—
AZ
Enumeration date
08/26/2005
Last updated
03/08/2011
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