Individual
DR. MARK JOHN COSTANTINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
195 KING AVE, ATHENS, GA 30606-2963
(706) 549-8306
(706) 549-8351
Mailing address
195 KING AVE, ATHENS, GA 30606-2963
(706) 549-8306
(706) 549-8351
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
15361
GA
Other
Enumeration date
10/04/2005
Last updated
09/28/2011
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