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1447266796

NPI Code Detail

MEDICARE: JEAN MARIE KOIS MD

MEDICARE: JEAN MARIE KOIS 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	207N00000X	Dermatology Physician	200401086	NC
2	207N00000X	Dermatology Physician	26801	SC
3	207N00000X	Dermatology Physician	40129	GA
4	207N00000X	Dermatology Physician	MD-045779-L	PA
5	207N00000X	Dermatology Physician	16461	AL

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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1447266796
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEAN MARIE KOIS MD

Provider Business Mailing Address
First Line	:	PO BOX 60447
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28260-0447
Country	:	US
Telephone Number	:	704-316-5070
Fax Number	:	704-316-5075

Provider Business Practice Location Address
First Line	:	9604 HOLLY POINT DR
Second Line	:
City	:	HUNTERSVILLE
State	:	NC
Zip	:	28078-4913
Country	:	US
Telephone Number	:	704-316-5070
Fax Number	:	704-316-5075

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

Provider Enumeration Date	:	07/31/2006
Last Update Date	:	02/20/2013

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Directions to “ JEAN MARIE KOIS MD” Practice Location

Language	Start Address	Practice Location

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