Provider Demographics
NPI:1205311594
Name:CASTEEL, CHRISTOPHER TOD (BOCO, BOCP)
Entity type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:TOD
Last Name:CASTEEL
Suffix:
Gender:M
Credentials:BOCO, BOCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6438 WOODWARD AVE
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48202-3216
Mailing Address - Country:US
Mailing Address - Phone:313-870-9610
Mailing Address - Fax:313-870-9620
Practice Address - Street 1:6438 WOODWARD AVE
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48202-3216
Practice Address - Country:US
Practice Address - Phone:313-870-9610
Practice Address - Fax:313-870-9620
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-02
Last Update Date:2019-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIC52545224P00000X, 222Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotistGroup - Multi-Specialty
No224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetistGroup - Multi-Specialty