Provider Demographics
NPI:1558578344
Name:KARANTH, KOTA SADASHIVA (MD)
Entity Type:Individual
Prefix:
First Name:KOTA
Middle Name:SADASHIVA
Last Name:KARANTH
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 1:4 HAWTHORNE DR
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:NH
Mailing Address - Zip Code:03110-6983
Mailing Address - Country:US
Mailing Address - Phone:603-472-8888
Mailing Address - Fax:603-472-9090
Practice Address - Street 1:4 HAWTHORNE DR
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:NH
Practice Address - Zip Code:03110-6983
Practice Address - Country:US
Practice Address - Phone:603-472-8888
Practice Address - Fax:603-472-9090
Is Sole Proprietor?:No
Enumeration Date:2007-05-17
Last Update Date:2021-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA254853207T00000X
NH16074207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH3090014Medicaid