VIJAYA GOPAL KOTHA MD PC (NPI# 1285126797) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285126797 |
| Entity Type | Organization |
| Organization Name | VIJAYA GOPAL KOTHA MD PC |
| Practice Address |
22101 Moross Rd Fl 6 Detroit MI 48236-2148 |
| Mailing Address |
591 Lake Shore Rd Grosse Pointe Shores MI 48236-2631 |
| Practice Telephone | 3133437560 |
| Mailing Telephone | 3135957336 |
| Enumeration Date | 2018-05-31 |
| Last Update Date | 2018-05-31 |
| Authorized Official Name | VIJAYA GOPAL KOTHA (OWNER) |
| Authorized Official Telephone | 3135957336 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | LICENSE NUMBER | 4301058577 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 215 North Ave Ste 200, Mount Clemens, MI 480431716 | 5863079010 |
| Street Address |
22101 MOROSS RD FL 6 |
| City | DETROIT |
| State | MI |
| Zip Code | 48236-2148 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093323966 | Khairya Fatouh | Pathology | 22101 Morros Road, Pathology Department, Detroit, Detroit, MI 48236 | 2020-07-16 |
| 1134744998 | Harish Harry Gidda | Internal Medicine | 22201 Moross Rd, Suite 50, Detroit, MI 48236 | 2020-06-08 |
| 1770107443 | Arshan Ali Khan | Internal Medicine | 22101 Moross Rd, Suite 50, Detroit, MI 48236 | 2020-05-29 |
| 1750901658 | Annika Van Wieren | Emergency Medicine | 22101 Moross Road, Emergency Department, Detroit, MI 48236 | 2020-04-21 |
| 1801449483 | Ishaq Azeem Asghar | Student in an Organized Health Care Education/Training Program | 22101 Moross Road, Pathology Department, Detroit, MI 48236 | 2019-07-22 |
| 1295290443 | Ascension St. John Hospital | Dietitian, Registered | 22201 Moross, Ste. 270, Detriot, MI 48236 | 2019-02-01 |
| 1548747413 | Abiodun Adenuga Adefarasin | Pharmacist | 20746 Mack Avenue, Gross Pointe Woods, MI 48236 | 2018-07-24 |
| 1629564042 | Hamza H Khan | Student in an Organized Health Care Education/Training Program | 22201 Moross, Professional Building 2, Suite 70, Detroit, MI 48236 | 2018-07-09 |
| 1235631664 | David Lee Williams | Physical Therapist | 159 Kercheval Avenue, Grosse Pointe Farms, MI 48236 | 2018-03-01 |
| 1164979720 | Memphie Morgan | Licensed Practical Nurse | 91527 Cheshire St., Grosse Pointe, MI 48236 | 2016-09-01 |
| Find all providers in zip 48236 | ||||
| Taxonomy Code | 2084P0800X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Psychiatry |
| A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851831713 | Jennifer L Rostamabadi-cook | Psychiatry & Neurology | 3031 W Grand Blvd Ste 600, Detroit, MI 48202-3014 | 2017-02-26 |
| 1447604608 | Zaid Baha | Psychiatry & Neurology | 14533 Mack Ave, Detroit, MI 48215-2520 | 2016-04-14 |
| 1487035127 | Shehryar Khan | Psychiatry & Neurology | 1350 W Bethune St Apt 1704, Henry Ford Hospital Guest Housing, Detroit, MI 48202-2666 | 2015-06-17 |
| 1508104373 | Thomas Sullivan | Psychiatry & Neurology | 16321 Mack Ave, Detroit, MI 48224-2756 | 2013-01-29 |
| 1588979421 | Tiwalola Olufunke Kolawole | Psychiatry & Neurology | 1 Ford Pl Ste 1f, Detroit, MI 48202-3450 | 2010-08-16 |
| 1033445754 | Robert Dale Smeed Jr. | Psychiatry & Neurology | 400 River Place Dr, Apt 4212, Detroit, MI 48207-5202 | 2009-10-30 |
| 1962699736 | Wendy Joy Besler | Psychiatry & Neurology | 3031 W Grand Blvd Ste 450, Detroit, MI 48202-3026 | 2007-09-26 |
| 1649497850 | Lindsay Rose Dykema | Psychiatry & Neurology | 2255 Atkinson St, Detroit, MI 48206-2010 | 2007-04-19 |
| 1316079270 | Bardia Gholami | Psychiatry & Neurology | 3901 Chrysler Dr Fl 3, Detroit, MI 48201 | 2007-03-09 |
| 1043350895 | Renee Harris | Psychiatry & Neurology | 7310 Woodward Avenue, Suite 601, Detroit, MI 48202 | 2007-02-08 |
| Find all providers in DETROIT | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.