Individual
DR. HANUMANTHA RAO KOLUSU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
609 35TH AVE STE 1A, MOLINE, IL 61265-6146
(563) 243-2022
(563) 243-4070
Mailing address
609 35TH AVE STE 1A, MOLINE, IL 61265-6146
(563) 243-2022
(563) 243-4070
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
31016
IA
207R00000X
Internal Medicine Physician
Primary
31016
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1134767
—
IA
Enumeration date
03/27/2006
Last updated
08/20/2019
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