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1548328800
MICHAEL MERRITT KOSTENKO
DANIELS, WV
NPI
1548328800
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
207Q00000X Family Medicine
(Licence: WV 1078)
Enumeration Date
2006-12-05
Last Update Date
2007-07-08
Business Address
DR. MICHAEL MERRITT KOSTENKO DO
3050 C & O DAM ROAD
DANIELS, WV 25832
Phone number: 304-763-0199
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Mailing Address
DR. MICHAEL MERRITT KOSTENKO DO
P O BOX 88 3050 C & O DAM ROAD
DANIELS, WV 25832
Phone number: 304-763-0199
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