Individual
ANA LUIZA FONTES DE AZEVEDO COSTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D., PHD
Contact information
Practice address
10 CENTENNIAL DR, PEABODY, MA 01960-7938
(781) 216-3400
Mailing address
10 CENTENNIAL DR, PEABODY, MA 01960-7938
(781) 216-3400
Taxonomy
Speciality
Code
Description
License number
State
207WX0110X
Pediatric Ophthalmology and Strabismus Specialist Physician
Primary
1020205
MA
207WX0110X
Pediatric Ophthalmology and Strabismus Specialist Physician
2022010573
MO
Other
Enumeration date
03/03/2020
Last updated
07/05/2024
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