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:
Health care specialties
| Specialty | Code | License # | 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 11 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1942373428 | NPPES |
| Michigan | MEDICAID | 2844302-10 | |
| Michigan | MEDICAID | 200872670 |
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