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General NPI Number Information
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NPI Number | 1336150259
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Entity Type | Individual
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Provider Name | BRIAN J KOSIAK MD
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Gender | Male
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Dates
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Enumeration Date | 08/10/2006
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Last Update Date | 03/08/2011
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Provider Practice Location Address
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Address Line | 2809 E HAMILTON AVE # 107
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City | EAU CLAIRE
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State | WI
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Zip | 54701-6863
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Country | US
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Telephone | 715-834-1555
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Fax | 715-835-2063
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Provider Business Mailing Address
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Address Line | 2809 E HAMILTON AVE # 107
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City | EAU CLAIRE
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State | WI
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Zip | 54701-6863
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Country | US
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Telephone | 715-834-1555
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Fax | 715-835-2063
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 36333
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 46560-20
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License Number State | WI
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 27582
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License Number State | CO
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