MEDICARE: NAGASAYANA RAO KOTHAPALLI MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208600000X	Surgery Physician	24169	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	50236	OTHER		BCBS

General Provider Information

NPI Number	:	1497734842
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NAGASAYANA RAO KOTHAPALLI MD

Provider Business Mailing Address
First Line	:	PO BOX 767
Second Line	:
City	:	SILER CITY
State	:	NC
Zip	:	27344
Country	:	US
Telephone Number	:	919-663-3161
Fax Number	:	919-663-2212

Provider Business Practice Location Address
First Line	:	315 EAST 3RD STREET
Second Line	:
City	:	SILER CITY
State	:	NC
Zip	:	27344
Country	:	US
Telephone Number	:	919-663-3161
Fax Number	:	919-663-2212

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/13/2006
Last Update Date	:	07/08/2007

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