Provider Demographics
NPI:1952692584
Name:KOTHARI, KUNAL DIPAK (MD, MBA)
Entity Type:Individual
Prefix:DR
First Name:KUNAL
Middle Name:DIPAK
Last Name:KOTHARI
Suffix:
Gender:M
Credentials:MD, MBA
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Mailing Address - Street 1:2101 E JEFFERSON ST
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-4908
Mailing Address - Country:US
Mailing Address - Phone:301-816-6879
Mailing Address - Fax:855-414-2812
Practice Address - Street 1:2101 E JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852
Practice Address - Country:US
Practice Address - Phone:301-816-6879
Practice Address - Fax:855-414-2812
Is Sole Proprietor?:No
Enumeration Date:2011-04-30
Last Update Date:2022-01-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD00785712085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology