Individual
STANISLAWA KRYSTYNA KOCZOROWSKA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
727 E NORTH ST, KENDALLVILLE, IN 46755-1225
(260) 343-0797
(260) 343-0799
Mailing address
PO BOX 727, KENDALLVILLE, IN 46755-0727
(260) 343-0797
(260) 343-0799
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
01033960
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000093825
BLUE SHIELD
—
01
—
7275
PHP
—
01
—
87726
UNITED HEALTH CARE
—
Enumeration date
08/05/2006
Last updated
07/08/2007
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