Provider Demographics
NPI:1720262546
Name:OSTERMAN COTES, M.D. PLLC
Entity type:Organization
Organization Name:OSTERMAN COTES, M.D. PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:OSTERMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:COTES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:304-766-3400
Mailing Address - Street 1:500 POPLAR ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SOUTH CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25309-1474
Mailing Address - Country:US
Mailing Address - Phone:304-766-3400
Mailing Address - Fax:304-766-3499
Practice Address - Street 1:500 POPLAR ST
Practice Address - Street 2:SUITE 200
Practice Address - City:SOUTH CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25309-1474
Practice Address - Country:US
Practice Address - Phone:304-766-3400
Practice Address - Fax:304-766-3499
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-28
Last Update Date:2008-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVD9983207VX0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WVSP00651Medicare PIN