Provider Demographics
NPI:1518715846
Name:KOTIAN, NIDHI JANARDHAN (MD)
Entity type:Individual
Prefix:MS
First Name:NIDHI
Middle Name:JANARDHAN
Last Name:KOTIAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9710 STATE AVE SEA MAR MARYSVILLE MEDICAL CLINIC,
Mailing Address - Street 2:
Mailing Address - City:MARYSVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98270
Mailing Address - Country:US
Mailing Address - Phone:360-653-1742
Mailing Address - Fax:
Practice Address - Street 1:1920 100TH ST SE, BLDG.B SEA MAR EVERETT MEDICAL CLINIC
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98208
Practice Address - Country:US
Practice Address - Phone:425-312-0202
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-10
Last Update Date:2024-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program