Healthcare Provider Details

I. General information

NPI: 1326138009
Provider Name (Legal Business Name): MICHAEL J. KOSNETT MD, MPH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/13/2006
Last Update Date: 11/28/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4495 HALE PKWY STE 301
DENVER CO
80220-6204
US

IV. Provider business mailing address

4495 HALE PKWY STE 301
DENVER CO
80220-6204
US

V. Phone/Fax

Practice location:
  • Phone: 303-571-5778
  • Fax: 877-554-1121
Mailing address:
  • Phone: 303-571-5778
  • Fax: 877-554-1121

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number34063
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code207PT0002X
TaxonomyMedical Toxicology (Emergency Medicine) Physician
License Number34063
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: