OLEG SERGEEVICH KOUSKOV

MERIDIAN, ID
NPI1053521203
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy207RP1001X Internal Medicine Pulmonary Disease
(Licence: ID  M11223)
Additional Taxonomies207RC0200X Internal Medicine Critical Care Medicine
(Licence: ID  M11223)
Enumeration Date2007-05-23
Last Update Date2014-01-23
Business Address
OLEG SERGEEVICH KOUSKOV MD
2347 E GALA ST
MERIDIAN, ID 83642-4881
Phone number: 208-323-3767
Mailing Address
OLEG SERGEEVICH KOUSKOV MD
190 E BANNOCK ST
BOISE, ID 83712-6241
Phone number: 208-381-2222