Individual
DR. HARESH K MOTWANI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD.
Contact information
Practice address
2133 VADALABENE DR, SUITE # 5B, MARYVILLE, IL 62062-5839
(618) 288-7605
(618) 288-7644
Mailing address
2133 VADALABENE DR, SUITE # 5B, MARYVILLE, IL 62062-5839
(618) 288-7605
(618) 288-7644
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
036117061
IL
207Q00000X
Family Medicine Physician
Primary
036.117061
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036117061
—
IL
05
—
036117061 5
—
IL
01
—
08232204
BLUE CROSS BLUE SHIELD
IL
01
—
08232205
BLUE CROSS BLUE SHIELD
IL
05
—
1598841025
—
MO
Enumeration date
10/27/2006
Last updated
07/20/2015
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