Individual
VANESKA BOTTINO DA COSTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
7950 W JEFFERSON BLVD, FORT WAYNE, IN 46804-4140
(260) 435-7001
(260) 435-9763
Mailing address
6920 POINTE INVERNESS WAY STE 200, FORT WAYNE, IN 46804-7934
(260) 479-3516
(260) 479-3520
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
01091713A
IN
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
T1020
TX
Other
Enumeration date
08/06/2015
Last updated
11/13/2023
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