DR. VIJAYA GOPAL KOTHA


Address: 11900 E Twelve Mile Rd, Suite 111, Warren, MI 48093-3472
Phone: 5865735300

DR. VIJAYA GOPAL KOTHA (NPI# 1386657427) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1386657427
Entity Type Individual
Full Name DR. VIJAYA GOPAL KOTHA
Credential MD
Practice Address 11900 E Twelve Mile Rd
Suite 111
Warren
MI 48093-3472
Practice Telephone 5865735300
Practice Fax Number 5865735304
Mailing Telephone 5865735300
Mailing Fax Number 5865735304
Enumeration Date 2006-08-13
Last Update Date 2007-07-08
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 2084P0800X Psychiatry & Neurology
Specialization: Psychiatry
4301058577 MI Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
BCBS 26OE011140 01
MI 4224674 05

Office Location

Street Address 11900 E TWELVE MILE RD
SUITE 111
City WARREN
State MI
Zip Code 48093-3472

Providers in the same location

NPI Name Taxonomy Address Enumeration
1578575106 Chilakamarri Ramesh Psychiatry & Neurology 11900 E Twelve Mile Rd, Suite #111, Warren, MI 48093-3472 2006-08-12
1306937339 Bal K Gupta Md PC Psychiatry & Neurology 11900 E Twelve Mile Rd, Suite 111, Warren, MI 48093-3472 2006-09-27
1225041353 Bal Krishan Gupta Psychiatry & Neurology 11900 E Twelve Mile Rd, Suite 111, Warren, MI 48093-3472 2006-08-13

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1023615986 Toleka Regina Taylor Nurse Anesthetist, Certified Registered St. John Macomb Hospital, 11800 East 12 Mile Road, Warren, MI 48093 2020-10-05
1679112676 Open Heart Communities Case Management 31310 Shaw Dr, Warren, MI 48093 2019-12-23
1538715636 3 Dove Medical Supplies Durable Medical Equipment & Medical Supplies 31201 Chicago Rd S Ste C101, Warren, MI 48093 2019-08-14
1568954600 Schreiber Cardiology, P.C. Internal Medicine 8545 Common Rd Ste 150, Warren, MI 48093 2018-06-05
1730686197 Lambro Seremetis Social Worker 12200 E. 12 Mile Road, Ste. 200, Warren, MI 48093 2018-04-11
1649775826 Ridge Downs Behavioral Analyst 31201 Chicago Rd South, Suite C- 202, Warren, MI 48093 2018-03-28
1144722737 Jessica Farraj Occupational Therapist 11800 E. 12 Mile Road, Warren, MI 48093 2018-02-28
1265930168 Leah Hanrahan Registered Nurse 11700 Amberle Dr., Warren, MI 48093 2018-01-25
1598271553 Pamela Marie Confer Occupational Therapist 11012 13 Mile Rd, Suite 200, Warren, MI 48093 2017-12-28
1831604347 Kate Jeanne Szczepanski Behavior Technician 31200 Chicago Rd S, Warren, MI 48093 2017-12-06
Find all providers in zip 48093

Taxonomy Information

Taxonomy Code 2084P0800X
Grouping Allopathic & Osteopathic Physicians
Classification Psychiatry & Neurology
Specialization Psychiatry

Taxonomy Definition

A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems.
Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1740651967 John L. Harrington Psychiatry & Neurology 4 Second Ave. Apt. #2, Warren, PA 16365 2015-10-14
1952727323 Shilin R Pandya Psychiatry & Neurology 27 Mountain Blvd Ste 3, Warren, NJ 07059-5605 2014-03-10
1376688770 David Schwartz Md PC Psychiatry & Neurology 12434 12 Mile Road, Suite 204, Warren, MI 48093 2007-02-21
1730192832 Anthony Petrilli Psychiatry & Neurology 27550 Schoenherr Rd, Suite 300, Warren, MI 48088-4798 2006-08-14
1578575106 Chilakamarri Ramesh Psychiatry & Neurology 11900 E Twelve Mile Rd, Suite #111, Warren, MI 48093-3472 2006-08-12
1932110319 Shin Jae Lee Psychiatry & Neurology 1400 Tod Ave Nw, Warren, OH 44485-2483 2006-08-10
1740206168 Lily Ann Marie Tencza Psychiatry & Neurology 28000 Dequindre Rd, Warren, MI 48092-2468 2006-07-15
1780649921 Eleanor Judith Kulis Psychiatry & Neurology 29856 Schoenherr Rd, Ste IIi, Warren, MI 48088 2006-04-19
1578528725 Barb Thielman Beebe Psychiatry & Neurology 29856 Schoenherr Road, Suite IIi, Warren, MI 48093 2006-04-19
1144206087 Brahmaiah Tandra Psychiatry & Neurology 8577 E Market St, Warren, OH 44484-2345 2005-12-22
Find all providers in WARREN

Competitor

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City WARREN
Zip Code 48093

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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