Individual
PETER ANTHONY COSTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-2403
(336) 713-4500
(336) 713-4501
Mailing address
5 BEAVER POND CT, STONY POINT, NY 10980-3518
(845) 729-7297
Taxonomy
Speciality
Code
Description
License number
State
2080P0206X
Pediatric Gastroenterology Physician
Primary
2019-00398
NC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/08/2013
Last updated
04/13/2021
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