Individual
MARC LYLE KOZAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
18111 PRINCE PHILIP DR, SUITE T-14, OLNEY, MD 20832-1513
(301) 774-4400
(301) 774-1034
Mailing address
18111 PRINCE PHILIP DR, SUITE T-14, OLNEY, MD 20832-1513
(301) 774-4400
(301) 774-1034
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
D44289
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
090907600
—
MD
Enumeration date
12/20/2005
Last updated
09/17/2013
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