Organization
PSYCHIATRY SUBSPECIALTIES CONSULTANTS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FERNANDO CASTRO-URRUTIA M.D. (CEO)
(517) 279-0248
Entity
Organization
Contact information
Practice address
259 E CHICAGO ST, COLDWATER, MI 49036-2046
(517) 279-0248
Mailing address
1131 N OSSEO RD, HILLSDALE, MI 49242-9714
(517) 523-3695
(517) 523-3311
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
SL078982
MI
2084P0805X
Geriatric Psychiatry Physician
Primary
FC067134
MI
2084P0805X
Geriatric Psychiatry Physician
SL078982
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
260A210220
BLUE CROSS BLUE SHIELD
MI
05
—
4653622
—
MI
05
—
4653631
—
MI
Enumeration date
10/03/2006
Last updated
06/14/2013
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