Individual
PAUL DAVID KOCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
835 S VAN BUREN ST, GREEN BAY, WI 54301-3526
(920) 593-3938
(920) 884-3271
Mailing address
5374 MOONLITE DR, DE PERE, WI 54115-8794
(920) 983-0116
(920) 884-3271
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
20415-020
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30980400
—
WI
Enumeration date
11/28/2006
Last updated
07/08/2007
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