Castellanos, Peter W

Castellanos, Peter W is an sole proprietor health care provider with primary practice located at 2225 Teton Plz Ste B , Idaho Falls ID 83404-6494. He recently has only one registered license in Allopathic & Osteopathic Physicians / Neurology with Special Qualifications in Child Neurology, which is considered as his primary health care specialty. Castellanos, Peter W can be contacted via phone (208) 529-4300.

Contact Information

Primary practice address
2225 Teton Plz Ste B Idaho Falls ID 83404-6494
Phone: (208) 529-4300
Fax: (208) 881-5121
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neurology with Special Qualifications in Child Neurology 2084N0402X 01048179 Indiana
Allopathic & Osteopathic Physicians / Neurology with Special Qualifications in Child Neurology 2084N0402X M10191 Idaho

Profile Details

NPI number 1811991474
LBN Legal business name Castellanos, Peter W
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 10th, 2005
Last updated Jul 29th, 2021 - about 5 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 1811991474 NPPES
Indiana MEDICAID 200173520
Indiana Other 000000089466

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