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Individual

DR. DAVID KOTLABA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
201 S MAIN ST, SUITE 1100, DANVILLE, VA 24541-2927
(434) 791-3009
(434) 791-3228
Mailing address
201 S MAIN ST, SUITE 1100, DANVILLE, VA 24541-2927
(434) 791-3009
(434) 791-3228

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
0101221387
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
265400
ANTHEM
VA
05
5836026
VA
01
690586T
NC MEDICAID
NC
Enumeration date
10/13/2006
Last updated
07/14/2016
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