Individual
MR. DANIEL JEREMY COSGROVE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
S64348
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A643480
—
CA
01
—
222046862
BLUE SHIELD
CA
01
—
P00647439
RAILROAD MEDICARE PTAN
CA
Enumeration date
11/09/2005
Last updated
07/08/2010
Update your record
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