Provider Demographics
NPI:1124169966
Name:KOSS, SETH JEREMY (MD)
Entity type:Individual
Prefix:DR
First Name:SETH
Middle Name:JEREMY
Last Name:KOSS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:108 FENNERTON RD
Mailing Address - Street 2:
Mailing Address - City:PAOLI
Mailing Address - State:PA
Mailing Address - Zip Code:19301-1107
Mailing Address - Country:US
Mailing Address - Phone:610-240-9299
Mailing Address - Fax:610-687-0702
Practice Address - Street 1:950 W VALLEY RD STE 2301
Practice Address - Street 2:
Practice Address - City:WAYNE
Practice Address - State:PA
Practice Address - Zip Code:19087-1846
Practice Address - Country:US
Practice Address - Phone:610-687-9334
Practice Address - Fax:610-687-0702
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-12
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMD066475L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine