Provider Demographics
NPI:1942653449
Name:COGSDILL, MICHAEL (PARAMEDIC)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:COGSDILL
Suffix:
Gender:M
Credentials:PARAMEDIC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 E HASKELL ST
Mailing Address - Street 2:
Mailing Address - City:WINNEMUCCA
Mailing Address - State:NV
Mailing Address - Zip Code:89445-3247
Mailing Address - Country:US
Mailing Address - Phone:775-623-5222
Mailing Address - Fax:775-304-9204
Practice Address - Street 1:118 EAST HASKELL STREEY
Practice Address - Street 2:
Practice Address - City:WINNEMUCCA
Practice Address - State:NV
Practice Address - Zip Code:89445
Practice Address - Country:US
Practice Address - Phone:775-623-5222
Practice Address - Fax:775-403-9204
Is Sole Proprietor?:No
Enumeration Date:2016-07-20
Last Update Date:2016-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV12834172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker