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Dr. Hanumantha R. Kolusu Md, Pc
Primary Care Clinic/Center in Moline, Illinois
NPI 1477717197

Dr. Hanumantha R. Kolusu Md, Pc is a Primary Care Clinic/Center based in Moline, IL and is specialized in Primary Care. Dr. Hanumantha R. Kolusu Md, Pc practices in Moline, IL. The NPI Number for Dr. Hanumantha R. Kolusu Md, Pc is 1477717197 and holds a License No. 31016 (Illinois).

The current practice location address for Dr. Hanumantha R. Kolusu Md, Pc is 609 35Th Ave Ste 1A, Moline, IL and can be reached out via phone at 563-243-2022 and via fax at 563-243-4070.

Location: 609 35Th Ave Ste 1A, Moline, IL, 61265-6146
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1477717197
Provider Name
Dr. Hanumantha R. Kolusu Md, Pc
Credential
Provider Entity Type
Organization
Address
609 35Th Ave Ste 1A, Moline, IL, 61265-6146
Phone Number
563-243-2022
Fax Number
563-243-4070
Provider Enumeration Date
07/11/2008
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
609 35Th Ave Ste 1A
City
Moline
State
Illinois
Zip
61265-6146
Phone Number
563-243-2022
Fax Number
563-243-4070
person
Provider Business Mailing Address Details
Address
609 35Th Ave Ste 1A
City
Moline
State
Illinois
Zip
61265-6146
Phone Number
563-243-2022
Fax Number
563-243-4070
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Primary Care
Taxonomy
261QP2300X
License No.
31016 (Iowa)
Definition
Definition to come...
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