Individual
EDWARD P COSTLOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
10 GERARD AVE, 214, TIMONIUM, MD 21093-3206
(410) 561-1585
(410) 252-0814
Mailing address
10 GERARD AVE, 214, TIMONIUM, MD 21093-3206
(410) 561-1585
(410) 252-0814
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
D19503
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
409013902
RAILROAD MEDICARE
—
01
—
41227801
BLUE SHIELD
—
Enumeration date
03/08/2007
Last updated
07/08/2007
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