Individual
DR. JOSEPH B KOSCIELNIAK JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5587 BROADWAY, MERRILLVILLE, IN 46410-2632
(219) 887-9506
(219) 884-3761
Mailing address
5587 BROADWAY, MERRILLVILLE, IN 46410-2632
(219) 887-9506
(219) 884-3761
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
01028974
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000081974
ANTHEM
IN
05
—
100353230A
—
IN
Enumeration date
07/15/2005
Last updated
01/12/2012
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