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Individual

FERNANDO R. DE CASTRO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
250 FOUNTAIN CT, LEXINGTON, KY 40509-1888
(859) 263-4444
(859) 254-1814
Mailing address
1221 S BROADWAY, LEXINGTON, KY 40504-2701
(859) 258-6200
(859) 258-6203

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
31195
KY
207ND0900X
Dermatopathology Physician
Primary
31195
KY
207NI0002X
Clinical & Laboratory Dermatological Immunology Physician
31195
KY
207NS0135X
Procedural Dermatology Physician
31195
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000044795
ANTHEM
01
0300072
UNITED HEALTHCARE
05
64311954
KY
Enumeration date
05/31/2005
Last updated
10/06/2023
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