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Individual

MARCO A CASTANEDA

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
12255 DEPAUL DRIVE, #675N, BRIDGETON, MO 63044
(314) 576-7213
(314) 576-4755
Mailing address
12255 DEPAUL DRIVE, #675N, BRIDGETON, MO 63044
(314) 729-4271
(314) 576-4755

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
R4A34
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
166464
HEALTHLINK
MO
01
P00015224
RAILROAD MEDICARE
Enumeration date
07/12/2005
Last updated
07/08/2007
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