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NPI Code Detail

MEDICARE: DR. KENNETH KOSCHNITZKI M.D.

MEDICARE:  DR. KENNETH  KOSCHNITZKI  M.D.
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
12080N0001XNeonatal-Perinatal Medicine Physician28286SC

Other Identifiers

General Provider Information

NPI Number : 1639131485
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KENNETH KOSCHNITZKI M.D.
Provider Business Mailing Address
First Line : 101 ROCKBERRY TER
Second Line :
City : SIMPSONVILLE
State : SC
Zip : 29681-4766
Country : US
Telephone Number : 864-286-6515
Fax Number :
Provider Business Practice Location Address
First Line : 125 COMMONWEALTH DR
Second Line :
City : GREENVILLE
State : SC
Zip : 29615-4812
Country : US
Telephone Number : 864-675-4414
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/05/2006
Last Update Date : 01/04/2016

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Directions to “ DR. KENNETH KOSCHNITZKI M.D.” Practice Location

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