Individual
DR. ZDZISLAW JERRY KOSEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
416 E MONROE ST, STE 200, SOUTH BEND, IN 46601-2371
(574) 232-8119
(574) 288-0235
Mailing address
416 E MONROE ST, STE 200, SOUTH BEND, IN 46601-2371
(574) 232-8119
(574) 288-0235
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
01056113A
IN
207L00000X
Anesthesiology Physician
01056113A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200381040
—
IN
Enumeration date
05/25/2006
Last updated
10/06/2008
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