Most Relevant Information
Provider Data
| NPI Number: | 1003292525 |
| Provider Name: | VANESKA BOTTINO DA COSTA M.D. |
| Entity Type: | Individual |
| Taxonomy Code: | 208000000X |
| Specialty: | Pediatrics |
| License Number: | 01091713A |
Most Important Dates
| Enumeration Date: | 08/06/2015 |
| Last Updated: | 11/13/2023 |
Provider Practice Location
7950 W JEFFERSON BLVD
FORT WAYNE
IN
468044140
Practice Location Phone/Fax
| Phone: | 2604357001 |
| Fax: | 2604359763 |
Provider Mailing Location
6920 POINTE INVERNESS WAY STE 200
FORT WAYNE
IN
468047934
Provider Mailing Phone/Fax
| Phone: | 2604793516 |
| Fax: | 2604793520 |
Suggested EMR
Pediatrics EMR