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NPI Code Detail

MEDICARE: DR. FREDERICK AUGUSTUS KOSINSKI PH.D.

MEDICARE:  DR. FREDERICK AUGUSTUS KOSINSKI  PH.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103T00000XPsychologist6301005994MI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11902086689OTHERMIGROUP NPI
2680A112130OTHERMIBLUE CROSS GROUP PIN

General Provider Information

NPI Number : 1386717593
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. FREDERICK AUGUSTUS KOSINSKI PH.D.
Provider Business Mailing Address
First Line : 9045 US HIGHWAY 31
Second Line :
City : BERRIEN SPRINGS
State : MI
Zip : 49103-1804
Country : US
Telephone Number : 269-473-2222
Fax Number : 269-473-6880
Provider Business Practice Location Address
First Line : 9045 US HIGHWAY 31
Second Line :
City : BERRIEN SPRINGS
State : MI
Zip : 49103-1633
Country : US
Telephone Number : 269-473-2222
Fax Number : 269-473-6880
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/16/2006
Last Update Date : 10/28/2008

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Directions to “ DR. FREDERICK AUGUSTUS KOSINSKI PH.D.” Practice Location

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