Individual
ANDRE THEODORE CASTELBUONO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3535 SOUTHERN BLVD, KETTERING, OH 45429-1221
(937) 384-6800
(937) 384-6896
Mailing address
3535 SOUTHERN BLVD, KETTERING, OH 45429-1221
(937) 384-6800
(937) 384-6896
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
50127
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4353212
BCBS OF TN
TN
01
—
P01223790
RAILROAD MEDICARE
TN
05
—
Q001134
—
TN
Enumeration date
06/04/2010
Last updated
07/07/2014
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