Edward P. Costlow, MD PA

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

D0019503 Issued in MD

Legal business name

EDWARD P. COSTLOW, MD PA

Practice address

10 Gerard Avenue
Suite 214
Timonium, MD 21093-3206

Phone

(410) 561-1585

Fax

(410) 252-0814

NPI assigned

May 28, 2015

Last updated

May 28, 2015By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Edward P. Costlow, MD PANPI 1275664450

Title

President

Phone

(410) 561-1585

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MD

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Edward P Costlow, MD

  • Internal Medicine Physician
  • Timonium, MD
  • NPI 1275664450
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1432771200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1432771200000",
    "number": "1104205764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 GERARD AVENUE",
            "address_2": "SUITE 214",
            "city": "TIMONIUM",
            "state": "MD",
            "postal_code": "210933206",
            "telephone_number": "410-561-1585",
            "fax_number": "410-252-0814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 GERARD AVENUE",
            "address_2": "SUITE 214",
            "city": "TIMONIUM",
            "state": "MD",
            "postal_code": "210933206",
            "telephone_number": "410-561-1585",
            "fax_number": "410-252-0814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDWARD P. COSTLOW, MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-28",
        "last_updated": "2015-05-28",
        "status": "A",
        "authorized_official_last_name": "COSTLOW",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "P.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "410-561-1585",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD PA"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D0019503",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Timonium, MD
• Providers in Timonium, MD by specialty
• Internal Medicine Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.