Individual
THOMAS A KOCOSHIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2401 W UNIVERSITY AVE, MUNCIE, IN 47303-3428
(765) 747-4349
Mailing address
2401 W UNIVERSITY AVE, MUNCIE, IN 47303-3428
(843) 554-9300
(843) 566-8780
Taxonomy
Speciality
Code
Description
License number
State
207ZP0101X
Anatomic Pathology Physician
Primary
01025385A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000007076
M PLAN
IN
01
—
000000083409
BLUE CROSS BLUE SHIELD
IN
01
—
020434700
BLACK LUNG
—
05
—
100332930
—
IN
05
—
2099554
—
OH
01
—
6470
PHYSICIAN HEALTH PLAN
IN
Enumeration date
08/17/2006
Last updated
02/24/2016
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