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Individual

DR. DAVID CHARLES KOTTRA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
200 MEMORIAL AVE., WESTMINSTER, MD 21157
(410) 876-7921
Mailing address
255 W MICHIGAN AVE, JACKSON, MI 49201-2218
(517) 787-6440

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
051152
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
012144400
MD
Enumeration date
08/15/2006
Last updated
02/18/2008
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