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Contact Information

MARK S COSTELLO JR, MD
169 ASHLEY AVE
ROOM 202 MAIN HOSPITAL MSC333
CHARLESTON, SC29425-8905
 Phone: 843-792-8299
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Otolaryngology

207Y00000X 04 Physician/Otolaryngology
Indicates primary specialty

NPI Profile & details for MARK S COSTELLO JR · (Male)

NPI Number 1497103550
Status Active
Credentials MD
Entity Individual
Enumeration date 05/31/2016
Last updated 05/31/2016 - About 10 years ago
Sole proprietor 1 Yes
Identifiers
  • SC License # MMD.39504 LL
Hospital affiliation(s)
  • CHRIST HOSPITAL - (Acute Care)
    2139 AUBURN AVENUE
    CINCINNATI, OH 45219
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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