Individual
RANGA R KOTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3630 WILLOWCREEK RD, PORTAGE, IN 46368-5075
(219) 759-5812
(219) 759-5890
Mailing address
2022 KELLE DR, CHESTERTON, IN 46304-8708
(219) 364-3616
(219) 364-3610
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
01038987
IN
208C00000X
Colon & Rectal Surgery Physician
01038987A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000086034
BCBS OF IN
IN
05
—
200007810A
—
IN
Enumeration date
06/21/2006
Last updated
09/11/2020
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