Provider Demographics
NPI:1063618619
Name:DOSTAL, COURTNEY (DO)
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:
Last Name:DOSTAL
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:709 DELAWARE AVENUE
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18015-1107
Mailing Address - Country:US
Mailing Address - Phone:484-526-3890
Mailing Address - Fax:866-829-9836
Practice Address - Street 1:709 DELAWARE AVENUE
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18015-1107
Practice Address - Country:US
Practice Address - Phone:484-526-3890
Practice Address - Fax:866-829-9836
Is Sole Proprietor?:No
Enumeration Date:2007-06-21
Last Update Date:2018-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB09716900207RP1001X
PAOS014897207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease