Individual
DR. CASEY GRANT COSTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
200 MEDICAL PARK BLVD, PETERSBURG, VA 23805-9274
(804) 765-5681
Mailing address
200 MEDICAL PARK BLVD, PETERSBURG, VA 23805-9274
(804) 765-5681
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
0116037906
VA
Other
Enumeration date
04/06/2023
Last updated
06/30/2026
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