MEDICARE: DR. MARTIN A KOSCHNITZKE MD

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	207V00000X	Obstetrics & Gynecology Physician	34193	CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1427043934
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARTIN A KOSCHNITZKE MD

Provider Business Mailing Address
First Line	:	2695 ROCKY MOUNTAIN AVE STE 150
Second Line	:
City	:	LOVELAND
State	:	CO
Zip	:	80538-9071
Country	:	US
Telephone Number	:	970-586-2200
Fax Number	:	970-577-4536

Provider Business Practice Location Address
First Line	:	1760 E KEN PRATT BLVD # 201
Second Line	:
City	:	LONGMONT
State	:	CO
Zip	:	80504-5311
Country	:	US
Telephone Number	:	720-718-8222
Fax Number	:	720-718-5986

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

Provider Enumeration Date	:	09/12/2005
Last Update Date	:	11/21/2024

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