Decastor, Laura

Decastor, Laura is an individual health care provider with primary practice located at 5215 Holy Cross Pkwy , Mishawaka IN 46545-1469. She recently has only one registered license in Allopathic & Osteopathic Physicians / Neonatal-Perinatal Medicine, which is considered as her primary health care specialty. Decastor, Laura can be contacted via phone (574) 335-5000.

Contact Information

Primary practice address
5215 Holy Cross Pkwy Mishawaka IN 46545-1469
Phone: (574) 335-5000
Fax: (574) 335-0760
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neonatal-Perinatal Medicine 2080N0001X 4301049652 Michigan

Profile Details

NPI number 1942373428
LBN Legal business name Decastor, Laura
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 15th, 2006
Last updated Oct 10th, 2014 - about 12 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 1942373428 NPPES
Michigan MEDICAID 2844302-10
Michigan MEDICAID 200872670

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