Castellano, Bradley David

Castellano, Bradley David is an sole proprietor health care provider with primary practice located at 1515 River Pl Suite 140, Braselton GA 30517-5602. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Podiatrist, which is considered as his primary health care specialty. Castellano, Bradley David can be contacted via phone (770) 648-5040.

Contact Information

Primary practice address
1515 River Pl Suite 140 Braselton GA 30517-5602
Phone: (770) 648-5040
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X POD000569 Georgia

Profile Details

NPI number 1922079151
LBN Legal business name Castellano, Bradley David
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 27th, 2006
Last updated Jan 20th, 2015 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1922079151 NPPES
Georgia MEDICAID 116103838A
Georgia Other 65107

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