Individual
DR. JAY H KOZLOWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D., F.A.C.C.
Contact information
Practice address
1 WILLIAM CARLS DR, SUITE 100, COMMERCE TOWNSHIP, MI 48382-2201
(248) 937-4764
(248) 937-4729
Mailing address
42557 WOODWARD AVE, SUITE 130, BLOOMFIELD HILLS, MI 48304-5206
(248) 322-3088
(248) 322-4175
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
4301041354
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0631936
BCBSM PIN
MI
01
—
0M89900
MEDICARE GROUP PIN
MI
05
—
4893226
—
MI
Enumeration date
01/10/2006
Last updated
09/19/2013
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