Provider Demographics
NPI:1447426432
Name:DA COSTA, VICTOR MANUEL (MD)
Entity Type:Individual
Prefix:DR
First Name:VICTOR
Middle Name:MANUEL
Last Name:DA COSTA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:16 S EUTAW ST
Mailing Address - Street 2:SUITE 500
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21201-1606
Mailing Address - Country:US
Mailing Address - Phone:410-328-3197
Mailing Address - Fax:
Practice Address - Street 1:1430 HARRISBURG PIKE
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-2615
Practice Address - Country:US
Practice Address - Phone:800-243-1455
Practice Address - Fax:717-606-1124
Is Sole Proprietor?:No
Enumeration Date:2008-04-30
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD75944207YP0228X
PAMD456676207YP0228X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YP0228XAllopathic & Osteopathic PhysiciansOtolaryngologyPediatric Otolaryngology