Dr. Chad Donald Costley, M.D.
Family Medicine in Decatur, GA. Individual provider (NPI-1).
NPI number1700832011
StatusActive
Last updated in NPPESJan 18, 2024
Details
- NPI
- 1700832011
- Entity type
- Individual (NPI-1)
- Name
- Dr. Chad Donald Costley
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- May 26, 2006
- Certification date
- Jan 18, 2024
- Last updated
- Jan 18, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | 054263 | GA | Yes |
Practice location
315 W Ponce De Leon Ave Ste 110Decatur, GA 30030-2441
Phone 404-371-9673 · Fax 844-246-7292
Mailing address
315 W Ponce De Leon Ave Ste 110Decatur, GA 30030-2441
Phone 404-537-2521 · Fax 678-515-4653
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