Koretzky, Emil D.

Koretzky, Emil D. is an individual health care provider with primary practice located at 200 1St St Sw , Rochester MN 55905-0001. He recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as his primary health care specialty. Koretzky, Emil D. can be contacted via phone (507) 284-2511.

Contact Information

Primary practice address
200 1St St Sw Rochester MN 55905-0001
Phone: (507) 284-2511
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatology 207N00000X 011414 Louisiana
Allopathic & Osteopathic Physicians / Dermatology 207N00000X 20192 Minnesota

Profile Details

NPI number 1316942931
LBN Legal business name Koretzky, Emil D.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 20th, 2005
Last updated Nov 20th, 2008 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1316942931 NPPES
Wisconsin MEDICAID 207N00000X
Wisconsin Other P00309450
Wisconsin MEDICAID 014939000
Wisconsin MEDICAID 1158607
Wisconsin MEDICAID ENROLLED

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