Edward P. Costlow, Md Pa | |
10 Gerard Avenue Suite 214 Timonium MD 21093-3206 | |
(410) 561-1585 | |
(410) 252-0814 |
Full Name | Edward P. Costlow, Md Pa |
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Speciality | Internal Medicine |
Location | 10 Gerard Avenue, Timonium, Maryland |
Authorized Official Name and Position | Edward P. Costlow (PRESIDENT) |
Authorized Official Contact | 4105611585 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Edward P. Costlow, Md Pa 10 Gerard Avenue Suite 214 Timonium MD 21093-3206 Ph: (410) 561-1585 | Edward P. Costlow, Md Pa 10 Gerard Avenue Suite 214 Timonium MD 21093-3206 Ph: (410) 561-1585 |
NPI Number | 1104205764 |
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Provider Enumeration Date | 05/28/2015 |
Last Update Date | 05/28/2015 |
Medicare PECOS PAC ID | 8527389444 |
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Medicare Enrollment ID | O20150604000360 |
Identifier | Type | State | Issuer |
---|---|---|---|
1104205764 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | D0019503 (Maryland) | Primary |
Provider Name | Edward Paul Costlow |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1275664450 PECOS PAC ID: 2961723887 Enrollment ID: I20150604000502 |
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