Provider Demographics
NPI:1043228059
Name:COSTLOW, JAMES S (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:S
Last Name:COSTLOW
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3824 NORTHERN PIKE
Mailing Address - Street 2:STE 700
Mailing Address - City:MONROEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15146-2141
Mailing Address - Country:US
Mailing Address - Phone:412-457-0060
Mailing Address - Fax:
Practice Address - Street 1:3824 NORTHERN PIKE
Practice Address - Street 2:STE 200
Practice Address - City:MONROEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15146-2141
Practice Address - Country:US
Practice Address - Phone:412-380-2800
Practice Address - Fax:412-380-2812
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2020-10-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD022329E207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
P000750OtherGATEWAY HEALTH PLAN
102259OtherUPMC HEALTH PLAN
110079450OtherRAILROAD MEDICARE
4077096OtherAETNA
PA000788563Medicaid
063157OtherBLUE SHIELD
102259OtherUPMC HEALTH PLAN
P000750OtherGATEWAY HEALTH PLAN
P000750OtherGATEWAY HEALTH PLAN