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General NPI Number Information
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NPI Number | 1912986506
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Entity Type | Individual
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Provider Name | WILLIAM CHRIS KOSTMAN M.D.
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Gender | Male
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Dates
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Enumeration Date | 01/11/2006
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Last Update Date | 05/24/2023
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Provider Practice Location Address
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Address Line | 10448 OLD OLIVE ST RD STE 200
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City | CREVE COEUR
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State | MO
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Zip | 63141
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Country | US
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Telephone | 314-597-8887
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Fax | 314-447-9559
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Provider Business Mailing Address
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Address Line | 10448 OLD OLIVE STREET RD
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City | CREVE COEUR
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State | MO
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Zip | 63141-5967
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Country | US
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Telephone | 314-966-8887
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Fax | 314-966-3869
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 113686
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License Number State | MO
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