MEDICARE: CHRISTOPHER COSTA MD

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
1	207R00000X	Internal Medicine Physician	27672	SC
2	207R00000X	Internal Medicine Physician	2004-01191	NC
3	208M00000X	Hospitalist Physician	D075058	MD

General Provider Information

NPI Number	:	1710950134
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTOPHER COSTA MD

Provider Business Mailing Address
First Line	:	7601 OSLER DRIVE
Second Line	:
City	:	TOWSON
State	:	MD
Zip	:	21204
Country	:	US
Telephone Number	:	410-427-2574
Fax Number	:	410-427-2054

Provider Business Practice Location Address
First Line	:	7601 OSLER DR
Second Line	:
City	:	TOWSON
State	:	MD
Zip	:	21204-7700
Country	:	US
Telephone Number	:	410-427-2574
Fax Number	:	410-427-2054

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/08/2006
Last Update Date	:	06/16/2017

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Directions to “ CHRISTOPHER COSTA MD” Practice Location

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