Individual
ANTHONY JAMES COSTA II
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1 GENESYS PKWY, GRAND BLANC, MI 48439-8065
(810) 606-5000
Mailing address
54752 SPYRIA DR, SHELBY TWP, MI 48315-1427
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
4351053098
MI
Other
Enumeration date
05/28/2024
Last updated
05/28/2024
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