Andrew Costerisan PA-C

NPI 1477825651 - Physician Assistant - 363A00000X

NPI Details
NPI 1477825651
Gender Male
Enumeration Date 02/02/2012
Last Updated 04/02/2014
Entity Type Individual
Active Over 4 years ago
Practice Location
2801 MATHERS RD
SPRINGFIELD IL, 62711-7064, US
Phone (217) 789-3600
Fax
Business Location
2801 MATHERS RD
SPRINGFIELD IL, 62711-7064, US
Phone (217) 789-3600
Fax
Toxanomy
Taxonomy Code 363A00000X
License State Florida
License Number PA 9106409
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According to our database, Mr. Andrew Costerisan PA-C NPI is 1477825651, taxonomy code is 363A00000X and license number is PA 9106409, license state is located at Florida. Andrew Costerisan PA-C physically located at 2801 Mathers Rd, Springfield IL, 62711-7064. NPI Number Andrew Costerisan PA-C has the Individual type.

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1477825651 NPI number is provided on an as is basis without warranty of any kind. 1477825651 is maintained by the National Plan & Provider Enumeration System. The contents of Andrew Costerisan PA-C are for informational purposes only.