| Dr Vijaya Gopal Kotha, MD | |
|
215 North Ave, Mount Clemens, MI 48043-1716 | |
| (313) 580-6760 | |
| Not Available |
| Full Name | Dr Vijaya Gopal Kotha |
|---|---|
| Gender | Male |
| Speciality | Psychiatry |
| Experience | 42 Years |
| Location | 215 North Ave, Mount Clemens, Michigan |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386657427 | NPI | - | NPPES |
| 4224674 | Medicaid | MI | |
| 26OE011140 | Other | BCBS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 4301058577 (Michigan) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Ascension Macomb Oakland Hosp-warren Campus | Warren, MI | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Henry Ford Health System | 0547178311 | 2304 |
| Bal K Gupta Md Pc | 5193779189 | 3 |
| Entity Name | Henry Ford Health System |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1134144801 PECOS PAC ID: 0547178311 Enrollment ID: O20031105000139 |
| Entity Name | Henry Ford Macomb Hospital Corporation |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1134265986 PECOS PAC ID: 7911808381 Enrollment ID: O20040119000142 |
| Entity Name | Bal K Gupta Md Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1306937339 PECOS PAC ID: 5193779189 Enrollment ID: O20050311000898 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Vijaya Gopal Kotha, MD 11900 E Twelve Mile Rd, Suite 111, Warren, MI 48093-3472 Ph: (586) 573-5300 | Dr Vijaya Gopal Kotha, MD 215 North Ave, Mount Clemens, MI 48043-1716 Ph: (313) 580-6760 |
Eric L Zimmerman, DO Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 1030 Harrington St Ste Ll001, Mount Clemens, MI 48043 Phone: 586-493-3297 | |
Dr. Margaret Samaan, Psychiatry & Neurology Medicare: Not Enrolled in Medicare Practice Location: 215 North Ave, Mount Clemens, MI 48043 Phone: 586-466-9950 | |
Dr. Nikesh I. Ardeshna, MD Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 1000 Harrington St, Mount Clemens, MI 48043 Phone: 313-613-6907 | |
Dr. Julie Anne-marie Burnham, D.O. Psychiatry & Neurology Medicare: May Accept Medicare Assignments Practice Location: 1030 Harrington St, Mount Clemens, MI 48043 Phone: 586-493-3188 Fax: 586-493-3191 | |
Dr. Pravin N Soni, M.D. Psychiatry & Neurology Medicare: Not Enrolled in Medicare Practice Location: 279 N Groesbeck Hwy, Mount Clemens, MI 48043 Phone: 586-627-0024 Fax: 586-627-0027 | |
Sara Razmjou-schwarz, MD Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 1030 Harrington St Ste Ll001, Mount Clemens, MI 48043 Phone: 586-493-8000 Fax: 586-493-3299 |