Individual
CAMDEN SHAY KOSOVAC
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
300 MAYTOWN RD, ELIZABETHTOWN, PA 17022-9314
(717) 367-1430
(717) 367-2895
Mailing address
7 DOCK HILL RD, MIDDLEBURG, PA 17842-8910
(570) 837-2123
(570) 837-2185
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
OA007753
PA
363A00000X
Physician Assistant
Primary
—
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1046623200001
—
PA
01
—
8Y0834
MEDICARE
PA
Enumeration date
05/27/2026
Last updated
07/30/2026
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