Organization
CHRISTOPHER P COSTA MD PC
Active
Other names
Costa Family Practice
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTOPHER P COSTA MD (OWNER)
(308) 537-2222
Entity
Organization
Contact information
Practice address
514 9TH STREET, GOTHENBURG, NE 69138-1917
(308) 537-2222
(308) 537-2960
Mailing address
514 9TH STREET, GOTHENBURG, NE 69138-1917
(308) 537-2222
(308) 537-2960
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
20028
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10025207300
RURAL HEALTH MEDICAID
NE
05
—
10025207400
—
NE
01
—
283850
RIVERBEND
—
Enumeration date
11/02/2006
Last updated
10/16/2007
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