Provider Demographics
NPI:1689375768
Name:KOZEL, OLIVIA ALEXANDRA (MD)
Entity type:Individual
Prefix:DR
First Name:OLIVIA
Middle Name:ALEXANDRA
Last Name:KOZEL
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:1301 N COLUMBIA RD STOP 9037
Mailing Address - Street 2:
Mailing Address - City:GRAND FORKS
Mailing Address - State:ND
Mailing Address - Zip Code:58202-9037
Mailing Address - Country:US
Mailing Address - Phone:701-777-3069
Mailing Address - Fax:
Practice Address - Street 1:1301 N COLUMBIA RD STOP 9037
Practice Address - Street 2:
Practice Address - City:GRAND FORKS
Practice Address - State:ND
Practice Address - Zip Code:58202-9037
Practice Address - Country:US
Practice Address - Phone:701-777-3069
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-15
Last Update Date:2025-05-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NDRL22452208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery