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General NPI Number Information
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NPI Number | 1659629780
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Entity Type | Organization
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Legal Business Name | NEVILLE H. KOTWAL, MD, LLC
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Dates
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Enumeration Date | 08/21/2012
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Last Update Date | 08/21/2012
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Provider Practice Location Address
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Address Line | 601 E BROAD ST
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City | BETHLEHEM
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State | PA
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Zip | 18018-6332
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Country | US
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Telephone | 610-882-1355
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Fax | 610-882-3181
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Provider Business Mailing Address
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Address Line | 601 E BROAD ST
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City | BETHLEHEM
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State | PA
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Zip | 18018-6332
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Country | US
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Telephone | 610-882-1355
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Fax | 610-882-3181
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Authorized Official
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Title or Position | OWNER
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Name | NEVILLE H. KOTWAL
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Credential | M.D.
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Telephone | 610-882-1355
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | MD044889L
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License Number State | PA
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