SEAN RYAN COSTELLO

RALEIGH, NC
NPI1568994093
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy207Q00000X Family Medicine
(Licence: NC  2022-00741)
Additional Taxonomies207Q00000X Family Medicine
(Licence: HI  DOS-1962)
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date2017-04-03
Last Update Date2024-09-06
Business Address
Dr. SEAN RYAN COSTELLO D.O.
7750 TEN TEN RD
RALEIGH, NC 27603-8852
Phone number: 919-235-1500
Mailing Address
Dr. SEAN RYAN COSTELLO D.O.
PO BOX 602195
CHARLOTTE, NC 28260-2195
Phone number: 919-350-0351