NPI 1053521203

Oleg Sergeevich Kouskov, MD

Practitioner Pulmonary Disease Physician Meridian, ID

Practice location

Address: 2347 E Gala St, Meridian, ID 83642-4881
Phone: (208) 323-3767
Mailing address: 190 E Bannock St, Boise, ID 83712-6241

Registered specialties (2)

Pulmonary Disease Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207RP1001X Licence M11223 (ID)

Other Internal Medicine providers in Idaho →

Critical Care Medicine (Internal Medicine) Physician

Allopathic & Osteopathic Physicians Taxonomy 207RC0200X Licence M11223 (ID)

Registry record

NPI: 1053521203
Entity type: Individual
Sex (as registered): Male
NPI issued: 23 May 2007
Record last updated: 23 Jan 2014

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.