Individual
DR. MATTHEW FRANCIS KOSCIELSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
621 MEMORIAL DR STE 302, SOUTH BEND, IN 46601-1073
(574) 246-9350
(574) 246-9370
Mailing address
3245 HEALTH DR STE 100, GRANGER, IN 46530-1380
(574) 647-3725
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
01038686A
IN
207RP1001X
Pulmonary Disease Physician
01038686A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000321947
BLUE CROSS BLUE SHIELD
IN
05
—
200039990
—
IN
01
—
P00083785
RAILROAD MEDICARE
IN
01
—
P00883981
RAILROAD MEDICARE
IN
Enumeration date
12/05/2005
Last updated
03/30/2026
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