Individual
DR. JOSE M.L. COSTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
100 HOSPITAL AVE, DU BOIS, PA 15801-1440
(814) 371-2200
(814) 375-4232
Mailing address
PO BOX 447, DU BOIS, PA 15801-0447
(814) 371-2200
(814) 375-4232
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
MD-021333-E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0009682580002
—
PA
Enumeration date
08/01/2006
Last updated
07/08/2007
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