Provider Demographics
NPI:1942418900
Name:COSTA, DANIEL BOTELHO (MD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:BOTELHO
Last Name:COSTA
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Gender:M
Credentials:MD
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Mailing Address - Street 1:30 ADELAIDE ST
Mailing Address - Street 2:#2
Mailing Address - City:JAMAICA PLAIN
Mailing Address - State:MA
Mailing Address - Zip Code:02130-2146
Mailing Address - Country:US
Mailing Address - Phone:617-524-0274
Mailing Address - Fax:617-667-3299
Practice Address - Street 1:330 BROOKLINE AVE
Practice Address - Street 2:SHAPIRO 9
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02215-5400
Practice Address - Country:US
Practice Address - Phone:617-667-2131
Practice Address - Fax:617-667-9919
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
MA220814207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology