| Dr. Hanumantha R. Kolusu Md, Pc | |
|
609 35th Ave Ste 1a Moline IL 61265-6146 | |
| (563) 243-2022 | |
| (563) 243-4070 |
| Full Name | Dr. Hanumantha R. Kolusu Md, Pc |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 609 35th Ave Ste 1a, Moline, Illinois |
| Authorized Official Name and Position | Hanumantha R. Kolusu (PRESIDENT) |
| Authorized Official Contact | 5632432022 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr. Hanumantha R. Kolusu Md, Pc 609 35th Ave Ste 1a Moline IL 61265-6146 Ph: (563) 243-2022 | Dr. Hanumantha R. Kolusu Md, Pc 609 35th Ave Ste 1a Moline IL 61265-6146 Ph: (563) 243-2022 |
| NPI Number | 1477717197 |
|---|---|
| Provider Enumeration Date | 07/11/2008 |
| Last Update Date | 08/15/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477717197 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 31016 (Iowa) | Primary |
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