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Individual

DR. JUSTIN COSTA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
1475 TANEY AVE STE 201, FREDERICK, MD 21702-5126
(301) 662-0133
Mailing address
1475 TANEY AVE STE 201, FREDERICK, MD 21702-5126
(301) 662-0133

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
0102202786
VA
208000000X
Pediatrics Physician
Primary
H0082753
MD

Other

Enumeration date
11/19/2009
Last updated
07/30/2021
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