Individual
DR. BRADLEY DAVID CASTELLANO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Contact information
Practice address
1515 RIVER PL, SUITE 140, BRASELTON, GA 30517-5602
(770) 648-5040
Mailing address
1515 RIVER PL, SUITE 140, BRASELTON, GA 30517-5602
(770) 648-5040
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
POD000569
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
116103838A
—
GA
01
—
65107
MEDICARE ID TYPE UNSPECIFIED
GA
Enumeration date
01/27/2006
Last updated
01/20/2015
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