Individual
EDNA C DECASTRO
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
103 11TH ST, STE 14, CHILLICOTHE, MO 64601-1676
(660) 646-2682
(660) 646-2688
Mailing address
13528 LIV 230, CHILLICOTHE, MO 64601-6398
(660) 707-0280
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
106544
MO
Other
Enumeration date
05/18/2006
Last updated
07/08/2007
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