Individual
BRIAN KOLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
710 MAIN ST, HARWICH PORT, MA 02646-1931
(508) 905-2800
Mailing address
710 MAIN ST, HARWICH PORT, MA 02646-1931
(508) 905-2800
(774) 209-3228
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
175611
NY
207RI0200X
Infectious Disease Physician
175611
NY
207RI0200X
Infectious Disease Physician
Primary
276952
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01475938
—
NY
Enumeration date
11/07/2005
Last updated
05/22/2019
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