Individual
DR. MICHAEL JOSEPH COSTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
11131 JOURNAL PARKWAY, KING GEORGE, VA 22485
(540) 785-7810
(540) 786-3099
Mailing address
11131 JOURNAL PARKWAY, KING GEORGE, VA 22485
(540) 625-2527
(540) 709-7211
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101052199
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1619080611
—
VA
Enumeration date
08/16/2006
Last updated
03/06/2015
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