Individual
ANJAIAH KODITYAL
Active
Individual
ANJAIAH KODITYAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
H8708
TX
207RP1001X
Pulmonary Disease Physician
Primary
H8708
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
116990100
FIRST CARE
—
05
—
131791905
—
TX
01
—
290005045
RAILROAD MEDICARE
—
01
—
5241453
AETNA
TX
01
—
OOJ89Z
BLUE CROSS BLUE SHIELD
TX
Enumeration date
08/05/2006
Last updated
12/10/2013
Update your record
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