Individual
DR. JOHN P. KOSTRZEWA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1963 MEMORIAL PARKWAY SW, SUITE 5, HUNTSVILLE, AL 35801
(256) 536-9300
(256) 535-9032
Mailing address
PO BOX 18066, HUNTSVILLE, AL 35804-8066
(256) 536-9300
(256) 535-9032
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
27811
AL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1437279601
—
AL
01
—
51103360
BLUECROSS BLUESHIELD OF AL
AL
01
—
51107582
BLUECROSS BLUESHIELD OF AL
AL
Enumeration date
05/22/2007
Last updated
12/22/2022
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