Kopal Sureshbhai Kotak

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

4351053257 Issued in MI

Practice address

1101 W University Dr
Rochester Hills, MI 48307-1863

Phone

(248) 601-4805

NPI assigned

Jul 6, 2024

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1720224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720224000000",
    "number": "1063258226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "418 TIMBERLEA DR APT 52",
            "city": "ROCHESTER HILLS",
            "state": "MI",
            "postal_code": "483092646",
            "telephone_number": "248-568-2724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 W UNIVERSITY DR",
            "city": "ROCHESTER HILLS",
            "state": "MI",
            "postal_code": "483071863",
            "telephone_number": "248-601-4805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOTAK",
        "first_name": "KOPAL",
        "middle_name": "SURESHBHAI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-06",
        "last_updated": "2024-07-06",
        "certification_date": "2024-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4351053257",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nina Mastracci Kolbe, D.O.
• Theodora Kolkena, L.AC
• Kamini Komarraju
• Ellen Robyn Konsol, OTR
• Eric Jason Kosnic, D.D.S.
• Dheeraj Kothakonda
• Priya D. Kothari, D.M.D.
• Anu John Kottukappally, NP-C
• Mark Alan Kowal, D.D.S.
• Sue Ellen Kozub, OTR/CHT

• Internal Medicine Physician in Rochester Hills, MI
• Providers in Rochester Hills, MI by specialty
• Internal Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.