Individual
DR. NICHOLAS JOSEPH COSTA II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
186 KIMEL PARK DR, WINSTON SALEM, NC 27103
(336) 277-2000
(336) 277-2050
Mailing address
PO BOX 751803, CHARLOTTE, NC 28275-1803
(336) 277-2000
(336) 277-2050
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
2019-00725
NC
207R00000X
Internal Medicine Physician
D0079810
MD
207RC0000X
Cardiovascular Disease Physician
2019-00725
NC
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
2019-00725
NC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/08/2011
Last updated
10/26/2020
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