Individual
DR. NEAL THOMAS DECOSTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
520 S ELM AVE, WEBSTER GROVES, MO 63119-3845
(314) 962-3464
Mailing address
501 GLADES RD, BOCA RATON, FL 33432-1419
(561) 939-5500
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
104301
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
206819716
—
MO
Enumeration date
01/12/2006
Last updated
05/22/2013
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