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NPI Code Detail

MEDICARE: SOPHIA KOTLIAR M.D.

MEDICARE: SOPHIA KOTLIAR M.D.
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
1207ZP0105XClinical Pathology/Laboratory Medicine PhysicianC10004615DE

Other Identifiers

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

General Provider Information

NPI Number : 1699775395
Entity Type Code : Individual
Provider Name (Legal Business Name) : SOPHIA KOTLIAR M.D.
Provider Business Mailing Address
First Line : 640 S STATE ST
Second Line :
City : DOVER
State : DE
Zip : 19901-3530
Country : US
Telephone Number : 302-744-7050
Fax Number :
Provider Business Practice Location Address
First Line : 106 BOW ST
Second Line : DEPARTMENT OF PATHOLOGY
City : ELKTON
State : MD
Zip : 21921-5544
Country : US
Telephone Number : 443-674-1289
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/26/2005
Last Update Date : 04/19/2017

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Directions to “ SOPHIA KOTLIAR M.D.” Practice Location

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