Costanzo, Paul Stephen

Costanzo, Paul Stephen is an individual health care provider with primary practice located at 404 Hazen St Suite L3, Paw Paw MI 49079-1040. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as his primary health care specialty. Costanzo, Paul Stephen can be contacted via phone (269) 657-1595.

Contact Information

Primary practice address
404 Hazen St Suite L3 Paw Paw MI 49079-1040
Phone: (269) 657-1595
Fax: (269) 657-1534
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 5601003700 Michigan

Profile Details

NPI number 1104845239
LBN Legal business name Costanzo, Paul Stephen
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 19th, 2006
Last updated Sep 27th, 2010 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1104845239 NPPES
Michigan Other 0H060020 BCBSM

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