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General NPI Number Information
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NPI Number | 1942271606
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Entity Type | Individual
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Provider Name | MARK ANDREW KOCAB MD
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Gender | Male
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Dates
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Enumeration Date | 01/31/2006
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Last Update Date | 05/08/2025
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Provider Practice Location Address
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Address Line | 601 JOHN ST STE M-302
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City | KALAMAZOO
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State | MI
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Zip | 49007-5357
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Country | US
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Telephone | 269-349-2266
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Fax |
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Provider Business Mailing Address
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Address Line | 1811 80TH AVE E
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City | PARRISH
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State | FL
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Zip | 34219-9259
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Country | US
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Telephone | 941-713-9246
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Fax |
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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 | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 74150
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 143712
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License Number State | MT
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Taxonomy #3
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 4301512571
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License Number State | MI
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Taxonomy #4
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | ME0774610
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License Number State | FL
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