Individual
DR. EUGENI T KOUZOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
835 S VAN BUREN ST, GREEN BAY, WI 54301-3526
(920) 433-8047
Mailing address
200 E WASHINGTON ST, P O BOX 8031, APPLETON, WI 54911-5490
(800) 236-1463
(920) 739-0124
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
47432-20
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
34598200
—
WI
Enumeration date
05/28/2006
Last updated
07/09/2007
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