Individual
DR. MICHAEL MERRITT KOSTENKO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
3050 C & O DAM ROAD, DANIELS, WV 25832
(304) 763-0199
(304) 763-2137
Mailing address
P O BOX 88, 3050 C & O DAM ROAD, DANIELS, WV 25832
(304) 763-0199
(304) 763-2137
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
1078
WV
Other
Enumeration date
12/05/2006
Last updated
07/08/2007
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