Individual
DR. ANNA-MARIA ALICIA DE COSTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD, PHD
Contact information
Practice address
4200 BECKNER RD, SANTA FE, NM 87507-3774
(505) 477-2200
Mailing address
1008 MINNEQUA AVE, PUEBLO, CO 81004-3733
(719) 557-5460
(719) 557-4648
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
66208-20
WI
2085R0001X
Radiation Oncology Physician
Primary
DR.0061777
CO
2085R0001X
Radiation Oncology Physician
MD2024-0260
NM
208600000X
Surgery Physician
LL36893
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
06926533
—
NM
05
—
9000173787
—
CO
Enumeration date
06/26/2014
Last updated
05/28/2025
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