Organization
RIVER VALLEY MEDICAL GROUP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RADHIKA N KOLLA MD (PHYSICIAN/OWNER)
(563) 271-3023
Entity
Organization
Contact information
Practice address
4626 PROGRESS DR STE C, DAVENPORT, IA 52807-3485
(563) 551-4200
(563) 441-9101
Mailing address
4626 PROGRESS DR STE C, DAVENPORT, IA 52807-3485
(563) 551-4200
(563) 441-9101
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
261QP2300X
Primary Care Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1598744096
—
IA
01
—
G81285
MEDICARE
—
Enumeration date
10/18/2021
Last updated
06/23/2023
Update your record
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