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Individual

DR. ANNA-MARIA DACOSTA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1129 HALE RD, MEMPHIS, TN 38116-6373
(901) 396-0390
Mailing address
1129 HALE RD, MEMPHIS, TN 38116-6373
(901) 396-0390

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD-042831-L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
001470208
PA
Enumeration date
07/25/2006
Last updated
07/27/2012
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