Individual
WILFRIDO RICARDO CASTANEDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
166 4TH ST E, SAINT PAUL, MN 55101-1421
(651) 292-2000
Mailing address
166 4TH ST E, SAINT PAUL, MN 55101-1421
(651) 292-2000
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
18513
MN
2085R0202X
Diagnostic Radiology Physician
Primary
51571
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ENROLLED
—
MN
01
—
P00873580
RAILROAD MEDICARE
MN
Enumeration date
01/29/2007
Last updated
04/10/2012
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