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Individual
THOMAS BOTTA
Active
Individual
THOMAS BOTTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
045288
CT
207RP1001X
Pulmonary Disease Physician
Primary
045288
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11696737
CAQH NUMBER
CT
01
—
1417177072
NPI NUMBER
—
Enumeration date
04/26/2007
Last updated
07/31/2008
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