Individual
SANDY DIANA KOTIAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
227 ST. PAUL PLACE, 4TH FLOOR, BALTIMORE, MD 21202-2102
(410) 783-5858
Mailing address
301 ST. PAUL PALCE, MEDICAL STAFF OFFICE, BALTIMORE, MD 21202
(410) 659-2802
Taxonomy
Speciality
Code
Description
License number
State
207RH0000X
Hematology (Internal Medicine) Physician
D70310
MD
207RX0202X
Medical Oncology Physician
Primary
D70310
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
032664000
—
MD
01
—
9754/0117
CAREFIRST
MD
Enumeration date
05/21/2007
Last updated
06/02/2016
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