Individual
LAURA D DIAZ DEL CASTILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
600 MARY ST, EVANSVILLE, IN 47747-0001
(812) 450-3405
(812) 450-6822
Mailing address
PO BOX 3407, EVANSVILLE, IN 47733-3407
(812) 450-6815
(812) 450-6822
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
01046896A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000507506
BCBS - DEACONESS MARY ST
IN
01
—
000000507596
BCBS - DEACONESS GATEWAY
IN
05
—
01360643
—
CO
Enumeration date
08/30/2006
Last updated
08/31/2007
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