Costello, John B
Costello, John B is an sole proprietor health care provider with primary practice located at 2821 N Ballas Rd Suite 165, Saint Louis MO 63131-2321. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Rheumatology. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Costello, John B can be contacted via phone (314) 995-9988.Contact Information
Primary practice address
2821 N Ballas Rd Suite 165
Saint Louis MO 63131-2321
Phone: (314) 995-9988
Fax: (866) 847-8598
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | R9162 | Missouri |
| Allopathic & Osteopathic Physicians / Rheumatology | 207RR0500X | R9162 | Missouri |
Profile Details
| NPI number | 1417062563 |
|---|---|
| LBN Legal business name | Costello, John B |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 20th, 2006 |
| Last updated | Jul 15th, 2013 - about 12 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 | 1417062563 | NPPES |
| Other | 2154714 | AETNA SPECIALIST | |
| Other | 87043 | AETNA SPECIALIST | |
| Other | 5502 | AETNA SPECIALIST | |
| Other | 112155277 | AETNA SPECIALIST | |
| Other | 951692 | AETNA SPECIALIST | |
| Other | 130260 | AETNA SPECIALIST |
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