Provider Demographics
NPI:1194828251
Name:COTRONEO, JOSEPH V (MD)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:V
Last Name:COTRONEO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:405 W GREENLAWN AVE
Mailing Address - Street 2:SUITE 305
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48910-2898
Mailing Address - Country:US
Mailing Address - Phone:517-483-4869
Mailing Address - Fax:517-483-4861
Practice Address - Street 1:405 W GREENLAWN AVE
Practice Address - Street 2:SUITE 305
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48910-2898
Practice Address - Country:US
Practice Address - Phone:517-483-4869
Practice Address - Fax:517-483-4861
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2023-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301069411208G00000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1018867OtherHEALTH ADVANTAGE NETWORK
MI4840124Medicaid
MI330C313780OtherBLUE CROSS TRADITIONAL
MI1018867OtherMCLAREN HEALTH PLAN
MI330C313780OtherBLUE CARE NETWORK
MI330C313780OtherBLUE CHOICE
MI300C313780OtherBLUE CROSS COMMUNITY BLUE
MI330C313780OtherBLUE PREFERRED PLUS
MI1800008OtherPHYSICIANS HEALTH PLAN
MIB18332OtherHEALTH NET
MI330C313780OtherBLUE CROSS TRADITIONAL
MI0P27680001Medicare ID - Type UnspecifiedMEDICARE