Healthcare Provider Details

I. General information

NPI: 1700020138
Provider Name (Legal Business Name): COSTAS A APOSTOLIS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/29/2009
Last Update Date: 01/18/2021
Certification Date: 01/18/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18181 PEARL RD STE B206
STRONGSVILLE OH
44136-6951
US

IV. Provider business mailing address

PO BOX 638269
CINCINNATI OH
45263-8269
US

V. Phone/Fax

Practice location:
  • Phone: 440-816-4910
  • Fax:
Mailing address:
  • Phone: 440-816-4910
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VF0040X
TaxonomyUrogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
License Number35-099119
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: