MR. EDUARD VOLFOVITCH KOTLYAROV MD NPI 1851348247

NPI Information

NPI: 1851348247
Provider Name: MR. EDUARD VOLFOVITCH KOTLYAROV, MD
Classification: Radiology - 2085R0202X
Entity Type: Individual

Specialization: Diagnostic Radiology

PECOS Registration: Yes

Address:
1375 N MAIN ST
LAPEER, MI
ZIP 48446
Phone: (810) 667-5500
Get Directions

MR. Eduard Volfovitch Kotlyarov, MD is a diagnostic radiology radiology in Lapeer, MI. The provider is a radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. MR. Eduard Volfovitch Kotlyarov, MD NPI is 1851348247. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1375 N MAIN ST
LAPEER, MI
ZIP 48446-350
Phone: (810) 667-5500

The NPI 1851348247 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 5/30/2006 and was last updated on 2/6/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2085N0904X	Radiology	Nuclear Radiology	0101032700	VIRGINIA	No
2	2085N0904X	Radiology	Nuclear Radiology	D0026059	MARYLAND	No
3	2085N0904X	Radiology	Nuclear Radiology	4301061744	MICHIGAN	No
4	2085N0904X	Radiology	Nuclear Radiology	MD11451	DISTRICT OF COLUMBIA	No
5	2085R0202X	Radiology	Diagnostic Radiology	D0026059	MARYLAND	No
6	2085R0202X	Radiology	Diagnostic Radiology	0101032700	VIRGINIA	No
7	2085R0202X	Radiology	Diagnostic Radiology	MD11451	DISTRICT OF COLUMBIA	No
8	2085R0202X	Radiology	Diagnostic Radiology	4301061744	MICHIGAN	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	2965193	MEDICAID	MICHIGAN
2	C88826	MEDICARE UPIN
3	CA5318	OTHER	MICHIGAN	MEDICARE RR GROUP PIN
4	3006399421	OTHER	MICHIGAN	BCBS PIN #
5	0D46002015	MEDICARE ID-TYPE UNSPECIFIED	MICHIGAN	INDIVIDUAL #
6	0F36125014	MEDICARE PIN	MICHIGAN
7	310D460020	OTHER	MICHIGAN	BCBS GROUP PIN
8	2965228	MEDICAID	MICHIGAN
9	300049506	OTHER	MICHIGAN	RRMC

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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