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Individual

CHANDRASEKHAR KOTA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1012 WATER ST, MEADVILLE, PA 16335-3468
(814) 337-8532
(814) 333-1025
Mailing address
1012 WATER ST, MEADVILLE, PA 16335-3468
(814) 333-2001
(814) 333-6236

Taxonomy

Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
35.064554
OH
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
MD426736
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000736969
ANTHEM
OH
01
000000737001
ANTHEM
OH
01
003359380
HIGHMARK BLUE CROSS BLUE SHIELD
PA
05
0055992
OH
05
1013266190002
PA
05
3810021787
WV
01
P01667340
RAILROAD MEDICARE
PA
Enumeration date
05/04/2006
Last updated
07/26/2016
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