Basic Information
| Provider Information | |||||||||
| NPI: | 1558681353 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KOTHARI | ||||||||
| FirstName: | DARSHAN | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 200 TRENT DRIVE BOX 3913 | ||||||||
| Address2: | |||||||||
| City: | DURHAM | ||||||||
| State: | NC | ||||||||
| PostalCode: | 27710 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9196841817 | ||||||||
| FaxNumber: | 9196818147 | ||||||||
| Practice Location | |||||||||
| Address1: | 200 TRENT DRIVE | ||||||||
| Address2: | |||||||||
| City: | DURHAM | ||||||||
| State: | NC | ||||||||
| PostalCode: | 27713 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9196841817 | ||||||||
| FaxNumber: | 9196818147 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/03/2010 | ||||||||
| LastUpdateDate: | 11/21/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RG0100X | 225269 | NC | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Gastroenterology |
No ID Information.