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Contact Information

MAKSIM KOZAK, PA
35 STATE AVE STE 1
FARIBAULT, MN55021
 Phone: 507-497-3528
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physician Assistant

363A00000X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for MAKSIM KOZAK · (Male)

NPI Number 1851858674
Status Active
Credentials PA (Physician Assistant)
Entity Individual
Enumeration date 02/28/2019
Last updated 03/11/2021 - About 5 years ago
Sole proprietor 1 No
Identifiers
  • MN License # 12822
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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