Healthcare Provider Details

I. General information

NPI: 1437779303
Provider Name (Legal Business Name): BRIAN MATTHEW COST DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/21/2020
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12300 MCCRACKEN RD
GARFIELD HEIGHTS OH
44125-2914
US

IV. Provider business mailing address

9500 EUCLID AVE
CLEVELAND OH
44195-0001
US

V. Phone/Fax

Practice location:
  • Phone: 216-581-0500
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XX0004X
TaxonomyOrthopaedic Foot and Ankle Surgery Physician
License Number34.017596
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: