Provider Demographics
NPI:1609994458
Name:KOTERBA, ALAN PAUL (MD)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:PAUL
Last Name:KOTERBA
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 1:840 US HIGHWAY 1 STE 235
Mailing Address - Street 2:
Mailing Address - City:NORTH PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33408-3835
Mailing Address - Country:US
Mailing Address - Phone:561-626-2006
Mailing Address - Fax:
Practice Address - Street 1:840 US HIGHWAY 1 STE 235
Practice Address - Street 2:
Practice Address - City:NORTH PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33408-3835
Practice Address - Country:US
Practice Address - Phone:561-626-2006
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-27
Last Update Date:2010-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301087873207R00000X
IL36121438207R00000X
FLME107004207KA0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergy
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine