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Organization

RANGA KOTA MD, PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
SUZI SINDE (CREDENTIALING SPECIALIST, CDS)
(219) 769-1670
Entity
Organization

Contact information

Practice address
3630 WILLOWCREEK RD, PORTAGE, IN 46368-5075
(219) 759-5812
Mailing address
3630 WILLOWCREEK RD, PORTAGE, IN 46368-5075

Taxonomy

Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
01038987
IN

Other

Enumeration date
09/03/2013
Last updated
09/03/2013
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