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General NPI Number Information
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NPI Number | 1891760922
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Entity Type | Organization
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Legal Business Name | TRAVERSE AREA HEMATOLOGY/ONCOLOGY P.C.
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Dates
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Enumeration Date | 02/22/2006
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Last Update Date | 10/31/2007
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Provider Practice Location Address
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Address Line | 5041 N ROYAL DR SUITE 2
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City | TRAVERSE CITY
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State | MI
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Zip | 49684-6986
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Country | US
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Telephone | 231-935-0700
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Fax | 231-935-0704
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Provider Business Mailing Address
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Address Line | 5041 N ROYAL DR SUITE 2
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City | TRAVERSE CITY
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State | MI
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Zip | 49684-6986
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Country | US
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Telephone | 231-935-0700
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Fax | 231-935-0704
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Authorized Official
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Title or Position | PRESIDENT
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Name | RICHARD P KOSINSKI
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Credential | MD
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Telephone | 231-935-0700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number |
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License Number State | MI
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