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Individual

DR. EMIL D. KORETZKY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
200 1ST ST SW, ROCHESTER, MN 55905-0001
(507) 284-2511
Mailing address
200 1ST ST SW, ROCHESTER, MN 55905-0001
(507) 284-2511

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
011414
LA
207N00000X
Dermatology Physician
Primary
20192
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
014939000
MN
05
1158607
LA
05
207N00000X
WI
05
ENROLLED
IA
01
P00309450
RAILROAD MEDICARE
MN
Enumeration date
06/20/2005
Last updated
11/20/2008
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