Individual
MR. MICHAEL TODD KOGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CP, BOCO
Contact information
Practice address
1547 BITTERSWEET CIR, JAMISON, PA 18929-1429
(267) 614-1538
(267) 897-9055
Mailing address
1547 BITTERSWEET CIR, JAMISON, PA 18929-1429
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0002035000
AMERIHEALTH HEALTH PLANS
PA
05
—
1012223920001
—
PA
01
—
2035
TRADITIONAL INDEMNITY
PA
01
—
3753541
AETNA
PA
Enumeration date
11/01/2006
Last updated
07/08/2007
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