Individual
DR. JOAV KOFMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
975 PORT WASHINGTON RD, GRAFTON, WI 53024-9201
(262) 329-1000
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
34140
WI
2084N0400X
Neurology Physician
4301095623
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100027062
—
WI
Enumeration date
06/17/2006
Last updated
11/30/2023
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