Individual
KANCHAN DINESH KOTAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
27 E MAIN ST, MIDDLETOWN, DE 19709-1445
(302) 378-2656
(302) 378-0343
Mailing address
27 E MAIN ST, MIDDLETOWN, DE 19709-1445
(302) 378-2656
(302) 378-0343
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
C10001916
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0000017601
—
DE
01
—
191214
MEDICARE
DE
Enumeration date
07/04/2006
Last updated
05/17/2011
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