Individual
CHARLES VLADIMIR KOTAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
912 32ND ST., STE A, ANACORTES, WA 98221
(360) 416-5750
(360) 416-5758
Mailing address
PO BOX 5127, EVERETT, WA 98206-5127
(360) 293-4343
(360) 588-1587
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD00035345
WA
208M00000X
Hospitalist Physician
MD00035345
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8229627
—
WA
01
—
GAB33047
GROUP
—
Enumeration date
04/04/2006
Last updated
05/08/2020
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