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1952346025
CHARLES MARK COSTABELL
LOUISVILLE, KY
NPI
1952346025
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
367500000X Nurse Anesthetist, Certified Registered
(Licence: KY 3004487)
Enumeration Date
2006-06-20
Last Update Date
2018-04-05
Business Address
CHARLES MARK COSTABELL CRNA
200 ABRAHAM FLEXNER WAY ANESTHESIA DEPT
LOUISVILLE, KY 40202-1818
Phone number: 502-587-4203
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Mailing Address
CHARLES MARK COSTABELL CRNA
100 E LIBERTY ST STE 800
LOUISVILLE, KY 40202-1428
Phone number: 502-587-4404
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