MARC LANCE COSTA (NPI# 1184655482) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184655482 |
| Entity Type | Individual |
| Full Name | MARC LANCE COSTA |
| Credential | MD |
| Practice Address |
527 Medical Park Dr Suite 202 Bridgeport WV 26330-9008 |
| Practice Telephone | 3049333850 |
| Practice Fax Number | 3049333859 |
| Mailing Telephone | 3049333850 |
| Mailing Fax Number | 3049333859 |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2012-06-26 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 174400000X | Specialist | MD060675L | PA | Other Service Providers |
| Y | 208600000X | Surgery | 19442 | WV | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | AETNA | 3133024 | 01 |
| PA | HEALTH ASSURANCE | G78377 | 01 |
| PA | GATEWAY | 1531290 | 01 |
| PA | 0019436000001 | 05 | |
| PA | CIGNA | 048032003 | 01 |
| PA | UPMC MEDICARE | 319922 | 01 |
| PA | HEALTH AMERICA | G78377 | 01 |
| PA | UNISON THREE RIVERS | 000000140320 | 01 |
| PA | BLUE CROSS BLUE SHIELD | 1461312 | 01 |
| PA | ADVANTRA MEDICARE | G78377 | 01 |
| Street Address |
527 MEDICAL PARK DR SUITE 202 |
| City | BRIDGEPORT |
| State | WV |
| Zip Code | 26330-9008 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134101660 | United Hospital Center Inc | Family Medicine | 527 Medical Park Dr, Suite 500, Bridgeport, WV 26330-9010 | 2005-11-18 |
| 1760967400 | Susan Rennae Kirkendall | Counselor | 527 Medical Park Dr, Bridgeport, WV 26330-9008 | 2018-09-28 |
| 1457886988 | Rachel S Holeman | Student in an Organized Health Care Education/Training Program | 527 Medical Park Dr, Suite 500, Bridgeport, WV 26330-9008 | 2017-04-21 |
| 1205360237 | Nathan E Russell | Student in an Organized Health Care Education/Training Program | 527 Medical Park Dr, Suite 500, Bridgeport, WV 26330-9008 | 2017-04-17 |
| 1255865275 | Brandon M Lewko | Emergency Medicine | 527 Medical Park Dr, Suite 500, Bridgeport, WV 26330-9008 | 2017-04-17 |
| 1144754177 | Premkumar Chandrakantbhai Patel | General Practice | 527 Medical Park Dr, Suite 500, Bridgeport, WV 26330-9008 | 2017-04-17 |
| 1922546175 | Leslie D. Mavromatis | Counselor | 527 Medical Park Dr, Bridgeport, WV 26330-9008 | 2017-02-08 |
| 1316491996 | Ellen Palmer Hoban | Nurse Practitioner | 527 Medical Park Dr, Suite 105, Bridgeport, WV 26330-9008 | 2016-08-11 |
| 1194170571 | Matthan Jackson | Family Medicine | 527 Medical Park Dr, Ste 500, Bridgeport, WV 26330-9008 | 2016-05-04 |
| 1447605837 | Arsalan Khawaja | Student in an Organized Health Care Education/Training Program | 527 Medical Park Dr, Ste 500, Bridgeport, WV 26330-9008 | 2016-05-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992303036 | Gage Mackenzie Chichester | Nurse Anesthetist, Certified Registered | 2673 Medical Park Drive, Bridgeport, WV 26330 | 2020-10-12 |
| 1851914105 | Melany Langhurst | Social Worker | 64 Professional Place, Suite 102, Bridgeport, WV 26330 | 2020-05-21 |
| 1245704980 | Adam Christopher Stonestreet | Social Worker | Community Care of Bridgeport, 65 Professional Place, Bridgeport, WV 26330 | 2019-01-16 |
| 1588146658 | Bridgeport Physical Therapy Services, Inc. | Occupational Therapist | 25 Sweetbrier Lane, Suite 105, Bridgeport, WV 26330 | 2018-09-05 |
| 1275040685 | White Oaks Assisted Living | Assisted Living Facility | 140 Professional Place White Oaks, Bridgeport, WV 26330 | 2018-01-08 |
| 1275049371 | Regional Eye Associates, Inc | Ophthalmology | 220 Southview Drive, Bridgeport, WV 26330 | 2017-12-27 |
| 1528586187 | Savanna Tamia Brown | Social Worker | 65 Professinal Place Suites 101,102103, Bridgeport, WV 26330 | 2017-09-05 |
| 1184079642 | Karla Kay Rinehart | Social Worker | 27 Trovato St., Suite 103, Bridgeport, WV 26330 | 2016-05-03 |
| 1396176756 | Willo Group LLC | Pharmacy | 460 E. Main Street, Bridgeport, WV 26330 | 2013-12-10 |
| 1891031878 | Sherri Michelle Dobson | Occupational Therapy Assistant | 1000 Maplewood Dr, Bridgeport, WV 26330 | 2012-12-20 |
| Find all providers in zip 26330 | ||||
| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518319458 | Muhammad Umer Afzaal | Surgery | 267 Grant St Fl St4, Bridgeport, CT 06610-2805 | 2016-07-04 |
| 1316378615 | Artem Dyatlov | Surgery | 2660 Main St Ste 110, Bridgeport, CT 06606-5301 | 2013-12-11 |
| 1952507972 | Sugam B Vasani | Surgery | 527 Medical Park Dr Ste 202, Bridgeport, WV 26330-9009 | 2007-06-26 |
| 1841350964 | Richard J Garvey | Surgery | 310 Mill Hill Ave, Bridgeport, CT 06610-2863 | 2006-12-11 |
| 1528136785 | Subhash O Shah | Surgery | 310 Mill Hill Avenue, Bridgeport, CT 06484 | 2006-12-04 |
| 1134193840 | Adam J Hansen | Surgery | 527 Medical Park Dr Ste 205, Bridgeport, WV 26330-9009 | 2006-02-17 |
| 1780678227 | Stuart Marcus | Surgery | 2800 Main St, St. Vincent's Medical Center, Bridgeport, CT 06606-4201 | 2005-09-09 |
| 1891131595 | Imran Baig | Surgery | 2800 Main St, Bridgeport, CT 06606 | 2013-05-21 |
| 1194089946 | Benjamin A Raymond | Surgery | 527 Medical Park Dr Ste 202, Bridgeport, WV 26330-9009 | 2012-06-26 |
| 1720349905 | United Hospital Center, Inc. | Surgery | 527 Medical Park Dr Ste 202, Bridgeport, WV 26330-9009 | 2012-06-04 |
| Find all providers in BRIDGEPORT | ||||
| City | BRIDGEPORT |
| Zip Code | 26330 |
Please comment or provide details below to improve the information on MARC LANCE COSTA.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.