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DR. CORINNE DIANNE COSTELLIC

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DO

Contact information

Practice address
44199 DEQUINDRE RD STE 612, TROY, MI 48085-1128
(248) 964-5170
(248) 964-5175
Mailing address
26901 BEAUMONT BLVD SUITE 3D, SOUTHFIELD, MI 48033-3849
(947) 522-1860
(947) 522-0307

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
5101018177
MI
2086X0206X
Surgical Oncology Physician
H0079964
MD

Other

Enumeration date
07/24/2009
Last updated
07/14/2022
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