MEDICARE: DR. RUTH D KOZLOWSKI DO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	RK008620	MI

General Provider Information

NPI Number	:	1174598270
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RUTH D KOZLOWSKI DO

Provider Business Mailing Address
First Line	:	PO BOX 18998
Second Line	:
City	:	BELFAST
State	:	ME
Zip	:	04915-4084
Country	:	US
Telephone Number	:	469-803-3000
Fax Number	:

Provider Business Practice Location Address
First Line	:	2455 UNION LAKE RD STE 101
Second Line	:
City	:	COMMERCE TOWNSHIP
State	:	MI
Zip	:	48382-3596
Country	:	US
Telephone Number	:	248-363-2239
Fax Number	:	248-363-3517

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/22/2006
Last Update Date	:	12/15/2025

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