Individual
JOHN MILTON COSTELLO JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
125 N FRANKLIN DR, SUITE 1, WASHINGTON, PA 15301-5892
(724) 225-6500
(724) 229-2170
Mailing address
125 N FRANKLIN DR, SUITE 1, WASHINGTON, PA 15301-5892
(724) 225-6500
(724) 225-8188
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
MD036851E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0011237940001
—
PA
01
—
0162212
BS
—
Enumeration date
04/13/2006
Last updated
06/08/2015
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