Provider Demographics
NPI:1407868995
Name:KOSSMANN, ROBERT JAN (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:JAN
Last Name:KOSSMANN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1650 HOSPITAL DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87505-4769
Mailing Address - Country:US
Mailing Address - Phone:505-982-4276
Mailing Address - Fax:505-982-4276
Practice Address - Street 1:1650 HOSPITAL DR
Practice Address - Street 2:SUITE 200
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87505-4769
Practice Address - Country:US
Practice Address - Phone:505-982-4276
Practice Address - Fax:505-982-4276
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-12
Last Update Date:2014-01-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NM94-290207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology