Provider Demographics
NPI:1790799427
Name:COSTEL, ESTHER E (MD)
Entity Type:Individual
Prefix:MRS
First Name:ESTHER
Middle Name:E
Last Name:COSTEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:ESTHER
Other - Middle Name:E
Other - Last Name:COSTEL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:4002 KRESGE WAY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40207
Mailing Address - Country:US
Mailing Address - Phone:502-897-1121
Mailing Address - Fax:502-897-1189
Practice Address - Street 1:4002 KRESGE WAY
Practice Address - Street 2:SUITE 100
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40207
Practice Address - Country:US
Practice Address - Phone:502-897-1121
Practice Address - Fax:502-897-1189
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY23150207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000051874OtherANTHEM
110168163OtherRR MEDICARE
KY64231509Medicaid
KYAC2112496OtherDEA
C75057Medicare UPIN
KY0523102Medicare ID - Type Unspecified