Individual
DR. EDWARD PAUL KOSANKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
730 S MAIN ST, CHEBOYGAN, MI 49721-2220
(231) 627-5666
(231) 627-5487
Mailing address
730 S MAIN ST, CHEBOYGAN, MI 49721-2220
(231) 627-5666
(231) 627-5487
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901002498
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
900A66502
BCBS
MI
05
—
94-5103234
—
MI
Enumeration date
10/04/2005
Last updated
02/15/2008
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