Individual
DR. K. ERIK KOSTELNIK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
50 SEWALL ST, PORTLAND, ME 04102-2624
(207) 775-3526
(207) 775-5658
Mailing address
50 SEWALL ST, PORTLAND, ME 04102-2624
(207) 775-3526
(207) 775-5658
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
014713
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
431499999
—
ME
Enumeration date
06/05/2006
Last updated
10/16/2008
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