Provider Demographics
NPI:1912248055
Name:DELACRUZ, PANFILO CASTRO (MD)
Entity type:Individual
Prefix:
First Name:PANFILO
Middle Name:CASTRO
Last Name:DELACRUZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8401 CONNECTICUT AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:CHEVY CHASE
Mailing Address - State:MD
Mailing Address - Zip Code:20815-5829
Mailing Address - Country:US
Mailing Address - Phone:301-304-8800
Mailing Address - Fax:301-652-4933
Practice Address - Street 1:8401 CONNECTICUT AVE STE 200
Practice Address - Street 2:
Practice Address - City:CHEVY CHASE
Practice Address - State:MD
Practice Address - Zip Code:20815-5829
Practice Address - Country:US
Practice Address - Phone:301-304-8800
Practice Address - Fax:301-652-4933
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-14
Last Update Date:2025-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101257413207R00000X
MDD0101357207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine