Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0401X | Family Doctor - Addiction Medicine | 02005282A | IN |
NPI | 1649482902 |
---|---|
Provider Name | Daniel R Cozadd |
First Address | Saginaw, MI 48602-4727 |
Second Address | Michigan City, IN 46360-9009 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/05/2007 |
Last Update Date | 16/06/2021 |