Individual
MIGUEL EDUARDO COSSIO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1075 S MAIN ST, SUITE 400, MADISON, GA 30650-2033
(706) 342-9664
Mailing address
1075 S MAIN ST, SUITE 400, MADISON, GA 30650-2033
(706) 342-9664
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
025337
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000289517A
—
GA
Enumeration date
05/22/2006
Last updated
06/06/2011
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