Provider Demographics
NPI:1346428802
Name:KOTSIS, ANDREW HARRY (DO)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:HARRY
Last Name:KOTSIS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:500 RENAISSANCE CTR
Mailing Address - Street 2:SUITE R560
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48243-1929
Mailing Address - Country:US
Mailing Address - Phone:313-473-3800
Mailing Address - Fax:313-396-5201
Practice Address - Street 1:500 RENAISSANCE CTR
Practice Address - Street 2:SUITE R560
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48243-1929
Practice Address - Country:US
Practice Address - Phone:313-473-3800
Practice Address - Fax:313-396-5201
Is Sole Proprietor?:No
Enumeration Date:2008-02-07
Last Update Date:2020-10-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI5101017496207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine