Individual
CHARLES KOTULSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9040 JACKSON AVE, TACOMA, WA 98431-0001
(253) 968-3885
Mailing address
84042 310TH ST, MADELIA, MN 56062-5417
(507) 380-4069
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
75407-20
WI
207Q00000X
Family Medicine Physician
Primary
ML60863184
WA
Other
Enumeration date
05/31/2018
Last updated
09/30/2024
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