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NPI Code Detail

MEDICARE: GEOFFREY B KOSTINER M.D.

MEDICARE: GEOFFREY B KOSTINER M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208800000XUrology Physician0101056471VA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1340014547OTHERRR/MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2174990OTHERVAANTHEM
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1235123530
Entity Type Code : Individual
Provider Name (Legal Business Name) : GEOFFREY B KOSTINER M.D.
Provider Business Mailing Address
First Line : 860 OMNI BLVD STE 128
Second Line :
City : NEWPORT NEWS
State : VA
Zip : 23606-4430
Country : US
Telephone Number : 757-232-8769
Fax Number : 757-232-8875
Provider Business Practice Location Address
First Line : 860 OMNI BLVD
Second Line : SUITE # 205
City : NEWPORT NEWS
State : VA
Zip : 23606-4237
Country : US
Telephone Number : 757-873-2562
Fax Number : 757-873-2570
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/01/2005
Last Update Date : 03/29/2023

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Directions to “ GEOFFREY B KOSTINER M.D.” Practice Location

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