Provider Demographics
NPI:1487626404
Name:ELMER J. KOZORA, MD., PC.
Entity Type:Organization
Organization Name:ELMER J. KOZORA, MD., PC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ELMER
Authorized Official - Middle Name:J
Authorized Official - Last Name:KOZORA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:734-266-2780
Mailing Address - Street 1:28801 PLYMOUTH RD
Mailing Address - Street 2:
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48150-2385
Mailing Address - Country:US
Mailing Address - Phone:734-266-2780
Mailing Address - Fax:
Practice Address - Street 1:32841 MIDDLEBELT RD
Practice Address - Street 2:SUITE 401
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334-1771
Practice Address - Country:US
Practice Address - Phone:248-626-9971
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-03
Last Update Date:2007-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty