Kostiuk, Theodore Anthony

Kostiuk, Theodore Anthony is an individual health care provider with primary practice located at 370 N 120Th Ave Ste 20 , Holland MI 49424-2196. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Orthopaedic Surgery, Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Orthopaedic Surgery of the Spine. Allopathic & Osteopathic Physicians / Orthopaedic Surgery of the Spine is his primary health care specialty. Kostiuk, Theodore Anthony can be contacted via phone (616) 396-5855.

Contact Information

Primary practice address
370 N 120Th Ave Ste 20 Holland MI 49424-2196
Phone: (616) 396-5855
Fax: (616) 396-5720
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X 02004389A Indiana
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Allopathic & Osteopathic Physicians / Orthopaedic Surgery of the Spine 207XS0117X 5101021584 Michigan

Profile Details

NPI number 1952544876
LBN Legal business name Kostiuk, Theodore Anthony
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 7th, 2009
Last updated Mar 4th, 2019 - about 7 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 1952544876 NPPES
Indiana MEDICAID 201244390

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