Doctor Name: | ANDREW JOHN COZADD |
NPI Number: | 1154685204 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PA-C |
License Number: | 1747 |
Business Practice Address: | 8290 University Ave Ne Suite 200 Fridley, MN - 554321847 |
Business Phone Number: | 7637869543 |
Business Fax Number: | 7637863320 |
Mailing Address: | 4200 Dahlberg Dr, Suite 300 GOLDEN VALLEY |
State: | MN |
Postal Code: | 554224840 |
Phone Number: | 9525125600 |
Fax Number: | 9525125651 |
NPI Enumeration Date: | 07/03/2012 |
NPI Last Update Date: | 07/03/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AS0400X |
License Number: | 1747 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MN |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Surgical |
Taxonomy Definition: |