Individual
MR. ANDREW J KOLP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
416 CONNABLE AVE, ER DEPARTMENT, PETOSKEY, MI 49770
(231) 487-4000
Mailing address
930 SPRING STREET, PETOSKEY, MI 49770
(800) 540-8739
(616) 975-9827
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
5101011708
MI
207P00000X
Emergency Medicine Physician
Primary
5101011708
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
114081526
—
MI
Enumeration date
05/25/2006
Last updated
10/10/2019
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