Individual
GEORGE T KOLETTIS
Active
Individual
GEORGE T KOLETTIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
01071673A
IN
207X00000X
Orthopaedic Surgery Physician
4301062980
MI
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
Primary
01071673A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000784327
ANTHEM
—
05
—
201117660
—
IN
01
—
P01128176
RAILROAD MEDICARE
—
Enumeration date
01/13/2006
Last updated
11/07/2016
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