Organization
PULMONARY & CRITICAL CARE ASSOCIATES, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MATTHEW FRANCES KOSCIELSKI M.D. (PRESIDENT)
(574) 246-9350
Entity
Organization
Contact information
Practice address
621 MEMORIAL DRIVE, SUITE 512, SOUTH BEND, IN 46601-1074
(574) 246-9350
(574) 246-9370
Mailing address
621 MEMORIAL DRIVE, SUITE 512, SOUTH BEND, IN 46601-1074
(574) 246-9350
(574) 246-9370
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
01038686
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200237190A
—
IN
01
—
DB0360
RAILROAD MEDICARE
IN
Enumeration date
04/10/2007
Last updated
02/11/2013
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