Individual
MICHAEL G KOELSCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
208 CORWIN LANE, KOKOMO, IN 46902-6612
(765) 453-8567
Mailing address
6626 E 75TH ST, SUITE 500, INDIANAPOLIS, IN 46250-2890
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
01049321A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000083152
BCBS PIN
—
05
—
200251540A
—
IN
01
—
224040199
MEDICARE PTAN
IN
01
—
770002492
RAILROAD MEDICARE PIN
—
01
—
P01270947
RR MEDICARE
IN
01
—
P01347724
MEDICARE RR PTAN
IN
Enumeration date
07/12/2006
Last updated
10/02/2023
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