Individual
DR. CHARLTON CASTILLO LACERNA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
19460 GRAND RIVER AVE, DETROIT, MI 48223
(313) 387-1097
(313) 387-8795
Mailing address
225 TOURAINE RD, GROSSE POINTE FARMS, MI 48236-3323
(808) 228-8127
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4301116455
MI
207Q00000X
Family Medicine Physician
60287621
WA
Other
Enumeration date
04/23/2009
Last updated
10/04/2023
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