Individual
DR. PATRICIA ANN COSTANZO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4 SEA OATS LN, SAVANNAH, GA 31411-3102
(912) 598-3960
(912) 598-3961
Mailing address
4 SEA OATS LN, SAVANNAH, GA 31411-3102
(912) 598-3960
(912) 598-3961
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
036709
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000835986C
—
GA
01
—
768294
BLUECROSS BLUESHIELD
GA
05
—
G36709
—
SC
Enumeration date
07/14/2005
Last updated
06/16/2008
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