Provider Demographics
NPI:1467807735
Name:KOTTE, ABHILASH (MD)
Entity Type:Individual
Prefix:DR
First Name:ABHILASH
Middle Name:
Last Name:KOTTE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44929 REVERE DR
Mailing Address - Street 2:
Mailing Address - City:NOVI
Mailing Address - State:MI
Mailing Address - Zip Code:48377-2547
Mailing Address - Country:US
Mailing Address - Phone:248-767-8265
Mailing Address - Fax:
Practice Address - Street 1:7575 GRAND RIVER
Practice Address - Street 2:209
Practice Address - City:BRIGHTON
Practice Address - State:MI
Practice Address - Zip Code:48114
Practice Address - Country:US
Practice Address - Phone:810-844-7950
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-25
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program