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Individual

MARK KOSTEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
NP

Contact information

Practice address
2122 HEALTH DR SW, WYOMING, MI 49519-9698
(616) 252-8403
(616) 252-8402
Mailing address
5900 BYRON CENTER AVE SW, MEDICAL ADMINISTRATION, WYOMING, MI 49519-9606
(616) 252-3243
(616) 252-0260

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704233048
MI

Other

Enumeration date
08/09/2012
Last updated
12/08/2017
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