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Individual

MARIA N KOSSAK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
D.O.

Contact information

Practice address
22074 MICHIGAN AVE, DEARBORN, MI 48124-2353
(313) 565-9510
(313) 565-4410
Mailing address
500 WAGNER CT, DEARBORN, MI 48124-2223
(313) 562-4037

Taxonomy

Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
5101010416
MI
207VX0000X
Obstetrics Physician
Primary
5101010416
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
4318019
MI
Enumeration date
06/13/2007
Last updated
09/11/2025
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