location
search-icon
institution
Jack M. Costa, M.d., P.c.
Specialist in Fairfax, Virginia
NPI 1972808335

Jack M. Costa, M.d., P.c. is a Specialist based in Fairfax, VA. Jack M. Costa, M.d., P.c. practices in Fairfax, VA. The NPI Number for Jack M. Costa, M.d., P.c. is 1972808335 and holds a License No. 0101028288 (Virginia).

The current practice location address for Jack M. Costa, M.d., P.c. is 3650 Joseph Siewick Dr, Fairfax, VA and can be reached out via phone at 703-391-2516 and via fax at 703-476-8244.

Location: 3650 Joseph Siewick Dr, Fairfax, VA, 22033-1710
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1972808335
Provider Name
Jack M. Costa, M.d., P.c.
Credential
Provider Entity Type
Organization
Address
3650 Joseph Siewick Dr, Fairfax, VA, 22033-1710
Phone Number
703-391-2516
Fax Number
703-476-8244
Provider Enumeration Date
01/17/2011
Last Update Date
03/09/2024
tick
Provider's Legacy Identifiers
Identifier Type State Issuer
9320 01 VA BLUE CROSS BLUE SHIELD
003539 01 VA ANTHEM
institution
Provider Business Practice Location Address Details
Address
3650 Joseph Siewick Dr
City
Fairfax
State
Virginia
Zip
22033-1710
Phone Number
703-391-2516
Fax Number
703-476-8244
person
Provider Business Mailing Address Details
Address
3650 Joseph Siewick Dr
City
Fairfax
State
Virginia
Zip
22033-1710
Phone Number
703-391-2516
Fax Number
703-476-8244
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
174400000X
License No.
0101028288 (Virginia)
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
semi-verified symbol
Badge

Use the following badge on your website to showcase your NPI number and verified status. In a field with over 8 million healthcare providers in the United States, it is important to establish your identity clearly. Displaying this badge signifies that your information is both accurate and up-to-date.