Provider Demographics
NPI:1912986506
Name:KOSTMAN, WILLIAM CHRIS (MD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:CHRIS
Last Name:KOSTMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:10448 OLD OLIVE STREET RD
Mailing Address - Street 2:
Mailing Address - City:CREVE COEUR
Mailing Address - State:MO
Mailing Address - Zip Code:63141-5967
Mailing Address - Country:US
Mailing Address - Phone:314-966-8887
Mailing Address - Fax:314-966-3869
Practice Address - Street 1:10448 OLD OLIVE ST RD
Practice Address - Street 2:STE 200
Practice Address - City:CREVE COEUR
Practice Address - State:MO
Practice Address - Zip Code:63141
Practice Address - Country:US
Practice Address - Phone:314-597-8887
Practice Address - Fax:314-447-9559
Is Sole Proprietor?:No
Enumeration Date:2006-01-11
Last Update Date:2023-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO113686207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO0900444OtherUNITED HEALTH CARE
MOG59783OtherMERCY #80
MO009219OtherEXCLUSIVE CHOICE
MO113052OtherBLUE CROSS BLUE SHIELD
MO55165OtherGHP
MO5596509OtherAETNA
MO335518OtherHEALTHLINK
MO113052OtherBLUE CROSS BLUE SHIELD
MO010011314Medicare ID - Type UnspecifiedMEDICARE #8
MO0900444OtherUNITED HEALTH CARE