Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Corinne Dianne Costellic, DO

Individual provider Surgical Oncology Physician · NPI 1194955104

Dr. Corinne Dianne Costellic, DO is a General Surgery in Troy, Michigan. Graduated from Lake Erie College of Osteopathic Medicine, Erie in 2009, 17 years ago. Practices with Beaumont Medical Group- Specialty Services, a 858-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in Maryland and Michigan.

Years since qualifying
17
Trained at
Lake Erie College of Osteopathic Medicine, Erie
Licensed in
MD, MI
In the registry since
2009
Specialties on file
2
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

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Practice location Address checks out

44199 Dequindre Rd Ste 612
Troy, MI 48085-1128
Phone: (248) 964-5170
Fax: (248) 964-5175
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 33101 Annapolis St, Wayne, MI 48184-2405 — (734) 467-2670
  • 33155 Annapolis St, Wayne, MI 48184-2405 — (734) 467-2670

Specialties & licences

Surgery Physician (primary) Taxonomy 208600000X · Licence 5101018177 (MI)
Surgical Oncology Physician Taxonomy 2086X0206X · Licence H0079964 (MD)

Record details

NPI number1194955104
Entity typeIndividual (Type 1)
GenderFemale
Credentials DO
Sole proprietorNo
NPI enumeratedJuly 24, 2009
Last updated in NPPESJuly 14, 2022
Certification dateJuly 14, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyGENERAL SURGERY
Medical schoolLAKE ERIE COLLEGE OF OSTEOPATHIC MEDICINE, ERIE
Graduated 2009 (17 years in practice)
Group practice Beaumont Medical Group- Specialty Services — 858 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations7 on file with Medicare

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