Individual
NANA KUTATELADZE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
111 CONTINENTAL DR, SUITE 406, NEWARK, DE 19713-4306
(302) 984-2577
(302) 368-1271
Mailing address
PO BOX 156, ELKTON, MD 21922-0156
(410) 398-4679
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
C1-0008503
DE
Other
Enumeration date
01/17/2008
Last updated
10/29/2013
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