Individual
MAKSIM KOZAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
35 STATE AVE STE 1, FARIBAULT, MN 55021
(507) 497-3528
Mailing address
2925 CHICAGO AVE, MINNEAPOLIS, MN 55407-1321
(612) 262-5000
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
12822
MN
Other
Enumeration date
02/28/2019
Last updated
03/11/2021
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