Individual
DR. DEAN P KOSTAKOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Contact information
Practice address
1380 UPPER HEMBREE RD, ROSWELL, GA 30076-1146
(770) 346-7500
(770) 346-8800
Mailing address
1380 UPPER HEMBREE RD, ROSWELL, GA 30076-1146
(770) 346-7500
(770) 346-8800
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
POD000605
GA
213ES0103X
Foot & Ankle Surgery Podiatrist
POD000605
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4407320
AETNA HEALTH PLANS
—
01
—
909671
BLUE CROSS BLUE SHIELD
GA
01
—
P00166113
RAIL ROAD MEDICARE
—
01
—
U28228
COVENTRY
GA
Enumeration date
09/22/2006
Last updated
09/11/2025
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