Individual
DR. ANIL KOTRU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
100 N ACADEMY AVE, DANVILLE, PA 17822-1348
(570) 271-6214
(570) 271-5613
Mailing address
100 N ACADEMY AVE, CREDENTIALS DEPT, DANVILLE, PA 17822-4903
(570) 271-6144
Taxonomy
Speciality
Code
Description
License number
State
204F00000X
Transplant Surgery Physician
Primary
MD428725
PA
208600000X
Surgery Physician
MD428725
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1016388210001
—
PA
Enumeration date
06/06/2006
Last updated
08/21/2020
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