Provider Demographics
NPI:1447384797
Name:KOTLYAREVSKA, KATERYNA V (MD)
Entity type:Individual
Prefix:DR
First Name:KATERYNA
Middle Name:V
Last Name:KOTLYAREVSKA
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Gender:F
Credentials:MD
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Mailing Address - Street 1:4869 COLLEGE ACRES DR
Mailing Address - Street 2:APARTMENT E
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28403-1743
Mailing Address - Country:US
Mailing Address - Phone:734-703-1256
Mailing Address - Fax:910-667-4639
Practice Address - Street 1:2131 S 17TH ST
Practice Address - Street 2:NEW HANOVER REGIONAL MEDICAL CENTER
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28401-7407
Practice Address - Country:US
Practice Address - Phone:910-667-3984
Practice Address - Fax:910-667-4639
Is Sole Proprietor?:No
Enumeration Date:2007-03-16
Last Update Date:2009-02-12
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Provider Licenses
StateLicense IDTaxonomies
MI4301086529208000000X, 390200000X
NC2008-016422080P0205X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0205XAllopathic & Osteopathic PhysiciansPediatricsPediatric Endocrinology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program