Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mr. Michael Cosulich, MD

Individual provider Dermatology Physician · NPI 1124439757

Mr. Michael Cosulich, MD is a Dermatology in Wall, New Jersey. Graduated from Georgetown University School of Medicine in 2013, 13 years ago. Practices with Cosulich Dermatology LLC, a 4-clinician group and accepts Medicare assignment. Licensed in Mississippi and New Jersey.

Years since qualifying
13
Trained at
Georgetown University School of Medicine
Licensed in
MS, NJ
In the registry since
2014
Specialties on file
3
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

See every abbreviation used in this directory →

Practice location Address checks out

3350 Highway 138 W Bldg 2 Ste 122
Wall, NJ 07719
Phone: (732) 280-1200
Fax: (732) 280-1207
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dermatology Physician (primary) Taxonomy 207N00000X · Licence 25MA09959400 (NJ)
Dermatology Physician Taxonomy 207N00000X · Licence 24922 (MS)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1124439757
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorYes
NPI enumeratedMay 16, 2014
Last updated in NPPESAugust 28, 2020
Certification dateAugust 28, 2020
Mailing address3350 Highway 138 West, Building 2, Suite 122, Wall, NJ 07719

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyDERMATOLOGY
Medical schoolGEORGETOWN UNIVERSITY SCHOOL OF MEDICINE
Graduated 2013 (13 years in practice)
Group practice Cosulich Dermatology Llc — 4 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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