Kosciuszko, Mark Edward
Kosciuszko, Mark Edward is an individual health care provider with primary practice located at 50 W Carleton Rd , Hillsdale MI 49242-1202. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Kosciuszko, Mark Edward can be contacted via phone (517) 439-2020.Contact Information
Primary practice address
50 W Carleton Rd
Hillsdale MI 49242-1202
Phone: (517) 439-2020
Fax: (517) 437-5577
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 4901002884 | Michigan |
Profile Details
| NPI number | 1841289774 |
|---|---|
| LBN Legal business name | Kosciuszko, Mark Edward |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 13th, 2005 |
| Last updated | Apr 8th, 2015 - about 10 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1841289774 | NPPES |
| Michigan | Other | 37252313 | VSP |
| Michigan | MEDICAID | 4696989 | VSP |
| Michigan | Other | 2230027 | VSP |
| Michigan | Other | 4414910001 | VSP |
| Michigan | Other | 900A210280 | VSP |
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