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Individual

LINDA A COSTIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DO

Contact information

Practice address
118 DOWELL AVE, BELLEFONTAINE, OH 43311-2305
(937) 593-5437
Mailing address
110 DOWELL AVE, BELLEFONTAINE, OH 43311-2305

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
34006035
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000212780
ANTHEM
01
0007901038
AETNA
01
12-01787
UHC
01
1956150005
CIGNA
05
2044255
OH
01
408680000E
NATIONWIDE
Enumeration date
06/11/2006
Last updated
02/18/2013
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