Individual
PETER J KOSBAB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
740 N MACOMB ST, MONROE, MI 48162-7813
(734) 240-5238
(734) 240-5273
Mailing address
740 N MACOMB ST, MONROE, MI 48162-7813
(734) 240-5238
(734) 240-5273
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
4704175440
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2710677
—
MI
05
—
4539216
—
MI
05
—
4838485
—
MI
Enumeration date
09/28/2006
Last updated
07/08/2007
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