Individual
DR. GILMAR COSTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1010 N KANSAS ST, WICHITA, KS 67214-3124
(316) 293-2665
Mailing address
1010 N KANSAS ST, WICHITA, KS 67214-3124
(316) 293-2665
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
94-10931
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
94-10931
KANSAS STATE BOARD OF HEALING ARTS
KS
Enumeration date
06/02/2022
Last updated
06/02/2022
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