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General NPI Number Information
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NPI Number | 1033598248
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Entity Type | Individual
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Provider Name | STEVEN D KOZUSKO MD, MED
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Gender | Male
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Dates
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Enumeration Date | 05/20/2015
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Last Update Date | 08/13/2024
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Provider Practice Location Address
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Address Line | 417 STATE ST STE 330
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City | BANGOR
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State | ME
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Zip | 04401-6638
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Country | US
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Telephone | 207-973-8881
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Fax | 207-973-8880
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Provider Business Mailing Address
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Address Line | 43 WHITING HILL RD STE 330
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City | BREWER
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State | ME
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Zip | 04412-1005
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Country | US
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Telephone | 207-973-5035
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Fax | 207-973-5042
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2082S0105X
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Taxonomy Name | Surgery of the Hand (Plastic Surgery) Physician
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License Number | MD28122
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License Number State | ME
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Taxonomy #2
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Taxonomy Code | 2086S0122X
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Taxonomy Name | Plastic and Reconstructive Surgery Physician
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License Number | MD28122
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License Number State | ME
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