Provider Demographics
NPI:1033153960
Name:KOZLOWSKI, CHRISTOPHER M (MD)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:M
Last Name:KOZLOWSKI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1155 MILL ST # MCM14
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502-1576
Mailing Address - Country:US
Mailing Address - Phone:775-982-5262
Mailing Address - Fax:775-982-5496
Practice Address - Street 1:1500 E 2ND ST
Practice Address - Street 2:SUITE 400
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-1262
Practice Address - Country:US
Practice Address - Phone:775-982-2400
Practice Address - Fax:775-982-2888
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2020-12-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NV15789207RC0000X, 207RI0011X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAGAB16961Medicare PIN
NVV110929Medicare PIN