Basic Information
| Provider Information | |||||||||
| NPI: | 1538293105 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KOEHN | ||||||||
| FirstName: | MICHAEL | ||||||||
| MiddleName: | BRANT | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | UNR FAMILY MEDICINE CTR | ||||||||
| Address2: | MAIL STOP 316 | ||||||||
| City: | RENO | ||||||||
| State: | NV | ||||||||
| PostalCode: | 895570001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7757846180 | ||||||||
| FaxNumber: | 7757844473 | ||||||||
| Practice Location | |||||||||
| Address1: | UNR FAMILY MEDICINE CTR | ||||||||
| Address2: | MAIL STOP 316 | ||||||||
| City: | RENO | ||||||||
| State: | NV | ||||||||
| PostalCode: | 895570001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7757846180 | ||||||||
| FaxNumber: | 7757844473 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/15/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | Y | Student, Health Care | Student in an Organized Health Care Education/Training Program |
No ID Information.