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Individual

JOSHUA T KOTOUC

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
101 STADIUM DR, MORGANTOWN, WV 26506-7911
(304) 598-4000
Mailing address
PO BOX 897, MORGANTOWN, WV 26507-0897
(304) 293-7401
(304) 293-6963

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
26945
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
051557034
AL
05
3810002340
WV
01
P00231782
RAILROAD MEDICARE
WV
Enumeration date
04/28/2006
Last updated
10/28/2008
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