Individual
MARK KOZAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
500 UNIVERSITY DR, HERSHEY, PA 17033-2360
(800) 243-1455
(717) 531-4077
Mailing address
PO BOX 858, MC A410, HERSHEY, PA 17033-0858
(800) 243-1455
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
MD050372L
PA
207RI0011X
Interventional Cardiology Physician
Primary
MD050372L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0014556500001
—
PA
Enumeration date
05/05/2006
Last updated
11/06/2019
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