Individual
MR. FREDERICK D KOSMACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
600 W SHELL CREEK RD, MINONG, WI 54859-9302
(715) 466-2201
(715) 466-2205
Mailing address
600 W SHELL CREEK RD, MINONG, WI 54859-9302
(715) 466-2201
(715) 466-2205
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
897
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42978900
—
WI
Enumeration date
06/16/2005
Last updated
05/08/2014
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