Organization
JACK M. COSTA, M.D., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JACK M. COSTA M.D. (OWNER)
(703) 391-2516
Entity
Organization
Contact information
Practice address
3650 JOSEPH SIEWICK DR, SUITE 202, FAIRFAX, VA 22033-1710
(703) 391-2516
(703) 476-8244
Mailing address
3650 JOSEPH SIEWICK DR, SUITE 202, FAIRFAX, VA 22033-1710
(703) 391-2516
(703) 476-8244
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
0101028288
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
003539
ANTHEM
VA
01
—
9320
BLUE CROSS BLUE SHIELD
VA
Enumeration date
01/17/2011
Last updated
01/17/2011
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us