Individual
ROBERT A KOSHNICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1027 WASHINGTON AVE, DETROIT LAKES, MN 56501-3409
(218) 847-5611
(218) 847-0881
Mailing address
1027 WASHINGTON AVE, DETROIT LAKES, MN 56501-3409
(218) 847-5611
(218) 847-0881
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
19195
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0122666
MEDICA #
MN
01
—
1031
NDBS #
ND
01
—
106057
MEDICA #
MN
01
—
107946
UCARE #
MN
05
—
17262
—
MN
01
—
50321KO
MNBS #
MN
01
—
61236KO
MNBS #
MN
05
—
636375000
—
MN
01
—
6406
NDBS #
MN
01
—
9044868
AMERICA'S PPO/ARAZ #
MN
01
—
DA9031015665
PREFERRED ONE #
MN
01
—
HP19530
HEALTHPARTNERS #
MN
01
—
MN100024
LHS/BANNERHEALTH #
MN
Enumeration date
06/07/2006
Last updated
11/22/2011
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