JACK MICHAEL COSTA

FAIRFAX, VA
NPI1144393935
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy207N00000X Dermatology
(Licence: VA  0101028288)
Enumeration Date2006-11-17
Last Update Date2010-12-30
Business Address
-- JACK MICHAEL COSTA M.D.
3650 JOSEPH SIEWICK DR SUITE 202
FAIRFAX, VA 22033-1710
Phone number: 703-391-2516
Mailing Address
-- JACK MICHAEL COSTA M.D.
3650 JOSEPH SIEWICK DRIVE SUITE 202
FAIRFAX, VA 22033
Phone number: 703-391-2516
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