Individual
DR. O'NEAL WILSON KOGER JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
4301053536
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
070012496
RAILROAD MEDICARE
MI
01
—
0706328251
INDIV B
MI
01
—
070F37332
BCBS
MI
05
—
3361759
—
MI
01
—
4113337
AETNA
MI
01
—
632825
NEW BCN
MI
01
—
9679933
CIGNA
MI
01
—
P67011
OLD BCN
MI
01
—
S38359
HAP
MI
Enumeration date
10/06/2006
Last updated
04/23/2014
Update your record
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