Individual
ADAM COSTARELLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1995 E STATE ST, SALEM, OH 44460-2423
(330) 332-1551
Mailing address
821 KREHL AVE, GIRARD, OH 44420-1968
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
35038439C
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0637949
—
OH
01
—
942460636176
CARESOURCE
OH
Enumeration date
06/08/2006
Last updated
07/08/2007
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