Individual
KEVIN A KOZICZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1501 W CHISHOLM ST, ALPENA, MI 49707-1401
(989) 356-7390
(989) 356-8013
Mailing address
14476 PARALLEL AVE, ALPENA, MI 49707-7988
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
4301072813
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0500410122
BCBS MICHIGAN
MI
05
—
4471880
—
MI
01
—
P00108494
RAILROAD MEDICARE
MI
Enumeration date
10/13/2006
Last updated
07/08/2007
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