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Individual

DR. JOSEPH PATRICK COSTELLO II

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1000 BLYTHE BLVD., MEB-SUITE 157 - ATTN: INSTITUTIONAL COORDINATOR, CHARLOTTE, NC 28203
(605) 610-7904
Mailing address
108 W SAINT ANDREWS DR, SIOUX FALLS, SD 57108-2956
(605) 610-7904

Taxonomy

Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary

Other

Enumeration date
08/14/2024
Last updated
06/23/2025
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