Organization
MARIA KOSSAK DO PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARIA N KOSSAK DO (PHYS OWNER)
(313) 565-9510
Entity
Organization
Contact information
Practice address
22074 MICHIGAN AVE, DEARBORN, MI 48124-2353
(313) 565-9510
(313) 565-4410
Mailing address
22074 MICHIGAN AVE, DEARBORN, MI 48124-2353
(313) 565-9510
(313) 565-4410
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4318019
—
MI
Enumeration date
06/25/2007
Last updated
08/22/2020
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