Individual
SREENIVASAN C KOTAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1763 PARK AVE SW, NORTON, VA 24273-1608
(276) 679-1700
(276) 679-6243
Mailing address
999 EXECUTIVE PARK BLVD, SUITE 201, KINGSPORT, TN 37660-4632
(423) 224-3250
(423) 224-3258
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
0101031294
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010146670
—
VA
Enumeration date
07/05/2006
Last updated
07/27/2012
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