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Individual
KRAIG M KOSCHMEDER
Active
Individual
KRAIG M KOSCHMEDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9104860
FL
363AM0700X
Medical Physician Assistant
PA9104860
FL
363AS0400X
Surgical Physician Assistant
PA9104860
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000733800
—
FL
01
—
373905
AVMED
FL
01
—
9808066
AETNA
FL
01
—
P01334010
RAILROAD MEDICARE
FL
01
—
Y0LQ9
FLORIDA BLUE
FL
Enumeration date
03/01/2007
Last updated
04/15/2025
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