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NPI Code Detail

MEDICARE: PETER N COSTA MD

MEDICARE: PETER N 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
1208100000XPhysical Medicine & Rehabilitation PhysicianG70318CA
2208100000XPhysical Medicine & Rehabilitation Physician7813NV

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
4250010880OTHERCAMEDICARE RAILROAD

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2NV9682OTHERNVBCBS
300G703180OTHERCAMEDI-CAL

General Provider Information

NPI Number : 1821089293
Entity Type Code : Individual
Provider Name (Legal Business Name) : PETER N COSTA MD
Provider Business Mailing Address
First Line : 973 MICA DR
Second Line : SUITE 201
City : CARSON CITY
State : NV
Zip : 89705-7255
Country : US
Telephone Number : 775-783-6190
Fax Number : 775-783-6191
Provider Business Practice Location Address
First Line : 973 MICA DRIVE
Second Line : SUITE 201
City : CARSON CITY
State : NV
Zip : 89705-7255
Country : US
Telephone Number : 775-783-6190
Fax Number : 775-783-6191
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/03/2005
Last Update Date : 07/20/2021

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Directions to “ PETER N COSTA MD” Practice Location

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