Costello, John
Costello, John is an individual health care provider with primary practice located at 171 Ashley Ave , Charleston SC 29425. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Pediatric Cardiology, Allopathic & Osteopathic Physicians / Pediatric Critical Care Medicine. Allopathic & Osteopathic Physicians / Pediatric Critical Care Medicine is his primary health care specialty. Costello, John can be contacted via phone (843) 792-1414.Contact Information
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 217260 | Massachusetts |
| Allopathic & Osteopathic Physicians / Pediatric Cardiology | 2080P0202X | 52686 | South Carolina |
| Allopathic & Osteopathic Physicians / Pediatric Critical Care Medicine | 2080P0203X | 52686 | South Carolina |
Profile Details
| NPI number | 1053302992 |
|---|---|
| LBN Legal business name | Costello, John |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 31st, 2005 |
| Last updated | Feb 18th, 2022 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1053302992 | NPPES |
| Massachusetts | MEDICAID | 2014416 | |
| Massachusetts | Other | 97288001 | |
| Massachusetts | Other | TUFTS HEALTH PLAN | |
| Massachusetts | MEDICAID | JC51504 | |
| Massachusetts | Other | 25-01706 | |
| Massachusetts | Other | J26530 | |
| Massachusetts | Other | 3253447 | |
| Massachusetts | Other | 26528 | |
| Massachusetts | Other | 32292 | |
| Massachusetts | Other | AA9211 | |
| Massachusetts | Other | J26530 | |
| Massachusetts | Other | J26530 |
Popular Providers
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Buckley, Jason Robert
171 Ashley Ave , Charleston SC 29425-8908 -
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