Provider Demographics
NPI:1538293105
Name:KOEHN, MICHAEL BRANT (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:BRANT
Last Name:KOEHN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:UNR FAMILY MEDICINE CTR
Mailing Address - Street 2:MAIL STOP 316
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89557-0001
Mailing Address - Country:US
Mailing Address - Phone:775-784-6180
Mailing Address - Fax:775-784-4473
Practice Address - Street 1:UNR FAMILY MEDICINE CTR
Practice Address - Street 2:MAIL STOP 316
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89557-0001
Practice Address - Country:US
Practice Address - Phone:775-784-6180
Practice Address - Fax:775-784-4473
Is Sole Proprietor?:No
Enumeration Date:2007-03-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program