Provider Demographics
NPI:1073599973
Name:CASTELLON, ROBERTO J (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERTO
Middle Name:J
Last Name:CASTELLON
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:7589 GLENWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:CANAL WINCHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:43110-8843
Mailing Address - Country:US
Mailing Address - Phone:614-920-3663
Mailing Address - Fax:614-920-3663
Practice Address - Street 1:2405 N COLUMBUS ST
Practice Address - Street 2:230
Practice Address - City:LANCASTER
Practice Address - State:OH
Practice Address - Zip Code:43130-8186
Practice Address - Country:US
Practice Address - Phone:740-681-8300
Practice Address - Fax:740-681-9095
Is Sole Proprietor?:No
Enumeration Date:2005-12-21
Last Update Date:2007-11-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OH35079006207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH4048431Medicare PIN
OHH35772Medicare UPIN