Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204F00000X | Transplant Surgeon | MD424706 | PA |
N | 208200000X | Surgeon | MD424706 | PA |
N | 208600000X | Surgeon | MD424706 | PA |
NPI | 1679545248 |
---|---|
Provider Name | Dr. Guilherme Costa |
First Address | Pittsburgh, PA 15213-3236 |
Second Address | Pittsburgh, PA 15213-3236 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/02/2006 |
Last Update Date | 18/02/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
101137531 | (05) | PA |
I21513 | (02) | PA |