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Contact Information

NICHOLAS J COSTA II, MD
186 KIMEL PARK DR
WINSTON-SALEM, NC27103
 Phone: 336-277-2000
 Fax: 336-277-2050
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical Cardiac Electrophysiology

207RC0001X 11 Physician/Internal Medicine
 

Cardiovascular Disease

207RC0000X 11 Physician/Internal Medicine
 

Internal Medicine

207R00000X 11 Physician/Internal Medicine
 

Student in an Organized Health Care Education/Training Program

390200000X
Indicates primary specialty

NPI Profile & details for NICHOLAS J COSTA II · (Male)

NPI # 1629368931
Status Active
Credentials MD
Entity Individual
Enumeration date 04/08/2011
Last updated 10/26/2020 - About 6 years ago
Sole proprietor 1 No
Identifiers
  • MD License # D0079810
  • NC License # 2019-00725
Hospital affiliation(s)
  • ASHE MEMORIAL HOSPITAL - (Critical Access)
    200 HOSPITAL AVE
    JEFFERSON, NC 28640
  • FORSYTH MEMORIAL HOSPITAL - (Acute Care)
    3333 SILAS CREEK PARKWAY
    WINSTON-SALEM, NC 27103
  • NORTHERN HOSPITAL OF SURRY COUNTY - (Acute Care)
    830 ROCKFORD ST
    MOUNT AIRY, NC 27030
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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