Individual
DR. MERRICK DOUGLAS KOZAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1221 LEE ST, CHARLOTTESVILLE, VA 22908-5051
(434) 924-5115
(434) 244-4504
Mailing address
PO BOX 9007, CHARLOTTESVILLE, VA 22906-9007
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
0101272020
VA
390200000X
Student in an Organized Health Care Education/Training Program
0116030312
VA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/02/2017
Last updated
09/02/2021
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