Doctor Name: | DR. MILTON S COSTA |
NPI Number: | 1629142674 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | 11841 |
Business Practice Address: | 347 Folly Rd Charleston, SC - 294122527 |
Business Phone Number: | 8437621440 |
Business Fax Number: | |
Mailing Address: | Po Box 751649, CHARLOTTE |
State: | NC |
Postal Code: | 282751649 |
Phone Number: | 8437891620 |
Fax Number: | 8437242440 |
NPI Enumeration Date: | 11/20/2006 |
NPI Last Update Date: | 10/19/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 11841 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | SC |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |