Individual
DR. ALAN RUSSELL KOSLOW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
30390
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2119164
—
IA
01
—
38296
BLUE CROSS & BLUE SHIELD
IA
Enumeration date
05/25/2006
Last updated
03/23/2010
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