Individual
LOUIS E COSTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
230 BEISER BLVD STE 200, DOVER, DE 19904-7792
(302) 505-0045
(888) 873-9653
Mailing address
142 GLENDA RD, DOVER, DE 19901-4922
(302) 505-0045
(888) 873-9653
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
C20010788
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102197454 0003
—
PA
01
—
C2-0010788
MEDICAL LICENSE
DE
01
—
OS012657
MEDICAL LICENSE
PA
Enumeration date
04/03/2007
Last updated
09/29/2021
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