Individual
DR. DAVID DA COSTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2799 W GRAND BLVD, WP 3 NICU, DETROIT, MI 48202-2608
(313) 916-3146
Mailing address
2799 W GRAND BLVD, WP 3 NICU, DETROIT, MI 48202-2608
Taxonomy
Speciality
Code
Description
License number
State
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
4301080608
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
350F361320
BCBSM
MI
05
—
4764031
—
MI
Enumeration date
03/20/2006
Last updated
07/20/2012
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