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General NPI Number Information
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NPI Number | 1689622714
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Entity Type | Individual
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Provider Name | CHANDRASEKHAR KOTA M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/04/2006
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Last Update Date | 07/26/2016
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Provider Practice Location Address
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Address Line | 1012 WATER ST
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City | MEADVILLE
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State | PA
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Zip | 16335-3468
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Country | US
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Telephone | 814-337-8532
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Fax | 814-333-1025
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Provider Business Mailing Address
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Address Line | 1012 WATER ST
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City | MEADVILLE
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State | PA
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Zip | 16335-3468
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Country | US
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Telephone | 814-333-2001
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Fax | 814-333-6236
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | 35.064554
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | MD426736
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License Number State | PA
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