Individual
DR. JUSTINE DE LA ROSA DECASTRO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
246 MATHIS FERRY RD STE 100, MOUNT PLEASANT, SC 29464-2987
(843) 900-6742
Mailing address
1050 JOHNNIE DODDS BLVD # 1116, MOUNT PLEASANT, SC 29464-3684
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
32980
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
329807
—
SC
01
—
P01214786
RR-MEDICARE
SC
Enumeration date
05/24/2007
Last updated
04/23/2026
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