Provider Demographics
NPI:1841260601
Name:BIGUS-COSLETT, MARIA T (DO)
Entity type:Individual
Prefix:DR
First Name:MARIA
Middle Name:T
Last Name:BIGUS-COSLETT
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:MARIA
Other - Middle Name:T
Other - Last Name:BIGUS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:521 MT PLEASANT DR
Mailing Address - Street 2:SUITE 101
Mailing Address - City:SCRANTON
Mailing Address - State:PA
Mailing Address - Zip Code:18503-1987
Mailing Address - Country:US
Mailing Address - Phone:570-346-7339
Mailing Address - Fax:570-341-3025
Practice Address - Street 1:521 MT PLEASANT DR
Practice Address - Street 2:SUITE 101
Practice Address - City:SCRANTON
Practice Address - State:PA
Practice Address - Zip Code:18503-1987
Practice Address - Country:US
Practice Address - Phone:570-346-7338
Practice Address - Fax:570-341-3025
Is Sole Proprietor?:No
Enumeration Date:2006-01-25
Last Update Date:2022-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS010787L207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1011314110003Medicaid
PA1011314110003Medicaid
PA083270YGDBMedicare PIN