| Doctor Name: | HEATHER KOZA |
| NPI Number: | 1194045526 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MD |
| License Number: | 4301104250 |
| Business Practice Address: | 7125 Orchard Lake Rd Suite 100 West Bloomfield, MI - 483223615 |
| Business Phone Number: | 2488657481 |
| Business Fax Number: | |
| Mailing Address: | 7125 Orchard Lake Rd, Suite 100 WEST BLOOMFIELD |
| State: | MI |
| Postal Code: | 483223615 |
| Phone Number: | 2488657481 |
| Fax Number: | |
| NPI Enumeration Date: | 06/08/2010 |
| NPI Last Update Date: | 10/15/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 4301104250 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |