Individual
STEPHEN EDWARD KOSTELIC
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2720 SUNSET BLVD, WEST COLUMBIA, SC 29169-4810
(803) 791-2350
(803) 791-2520
Mailing address
PO BOX 6069, WEST COLUMBIA, SC 29171-6069
(803) 791-2350
(803) 791-2520
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
52197
SC
207P00000X
Emergency Medicine Physician
LL52197
SC
Other
Enumeration date
05/03/2018
Last updated
04/19/2023
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