Sousou, Costa H

Sousou, Costa H is an individual health care provider with primary practice located at 1212 Well St , Onalaska WI 54650-2668. He recently has only one registered license in Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, which is considered as his primary health care specialty. Sousou, Costa H can be contacted via phone (608) 785-0940.

Contact Information

Primary practice address
1212 Well St Onalaska WI 54650-2668
Phone: (608) 785-0940
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X 54770 Minnesota
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X 54981 Wisconsin
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X CP209585 Oregon

Profile Details

NPI number 1225032857
LBN Legal business name Sousou, Costa H
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 10th, 2005
Last updated Jan 25th, 2024 - about 11 months 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1225032857 NPPES
Wisconsin MEDICAID 100011679

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