Individual
DR. NICHOLAS SALVATORE COSTANZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
4225 FROST GRASS DR, HENRY FORD MACOMB HOSPITALS, FORT WAYNE, IN 46845-8010
(248) 404-0471
Mailing address
4225 FROST GRASS DR, HENRY FORD MACOMB HOSPITALS, FORT WAYNE, IN 46845-8010
(248) 404-0471
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
02004817A
IN
Other
Enumeration date
03/26/2013
Last updated
02/14/2017
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