Provider Demographics
NPI:1831162841
Name:KOSIC, NEVEN (MD)
Entity type:Individual
Prefix:
First Name:NEVEN
Middle Name:
Last Name:KOSIC
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 1:4815 FRIENDSHIP AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15224-1721
Mailing Address - Country:US
Mailing Address - Phone:412-682-5992
Mailing Address - Fax:412-682-5915
Practice Address - Street 1:740 E STATE ST
Practice Address - Street 2:
Practice Address - City:SHARON
Practice Address - State:PA
Practice Address - Zip Code:16146-3328
Practice Address - Country:US
Practice Address - Phone:724-983-1980
Practice Address - Fax:724-983-1295
Is Sole Proprietor?:No
Enumeration Date:2006-02-09
Last Update Date:2017-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD066301-L207R00000X
PAMD066301207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0017250020003Medicaid
PA0017250020003Medicaid
PA022660R7RMedicare PIN