Active NPI
Mari Paz Castanedo Tardan, M.D.
- Dermatology Physician
- Ann Arbor, MI
National Provider Identifier
1578881041
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- 4301108544
- Practice address
- 24 Frank Lloyd Wright Drive
Lobby H Suite 2350
Ann Arbor, MI 48105-9484 - Phone
- (734) 936-4054
- NPI assigned
- May 9, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | 16782 | NH | |
| Dermatology Physician | 207N00000X | 4301108544 | MI | Primary |
Addresses
Primary practice location
24 Frank Lloyd Wright Drive
Lobby H Suite 2350
Ann Arbor, MI 48105-9484
Mailing address
3621 S State St
700 KMS Place
Ann Arbor, MI 48108
Phone (734) 936-2047
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Interoperability endpoints
- mcastanedotardan668735@direct.med.umich.edu
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1273363200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1438646400000",
"number": "1578881041",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3621 S STATE ST",
"address_2": "700 KMS PLACE",
"city": "ANN ARBOR",
"state": "MI",
"postal_code": "48108",
"telephone_number": "734-936-2047"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "24 FRANK LLOYD WRIGHT DRIVE",
"address_2": "LOBBY H SUITE 2350",
"city": "ANN ARBOR",
"state": "MI",
"postal_code": "481059484",
"telephone_number": "734-936-4054"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CASTANEDO TARDAN",
"first_name": "MARI PAZ",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-05-09",
"last_updated": "2015-08-04",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "NH",
"license": "16782",
"primary": false
},
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "MI",
"license": "4301108544",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ann Arbor, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.