Organization
ENHANCED MEDICAL CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK EDWARD COSTA M.D. (PARTNER)
(617) 777-4080
Entity
Organization
Contact information
Practice address
361 WOODWARD ST, WABAN, MA 02468-2027
(617) 777-4080
(617) 344-0070
Mailing address
361 WOODWARD ST, WABAN, MA 02468-2027
(617) 777-4080
(617) 344-0070
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
54772
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3131874
—
MA
Enumeration date
04/12/2007
Last updated
08/22/2020
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