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 |
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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 |
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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 |
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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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