MEDICARE: JAMES EDWARD GOTTESMAN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208800000X	Urology Physician	MD00013055	WA

General Provider Information

NPI Number	:	1144293184
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES EDWARD GOTTESMAN MD

Provider Business Mailing Address
First Line	:	1221 MADISON
Second Line	:	SUITE 1210
City	:	SEATTLE
State	:	WA
Zip	:	98104-1370
Country	:	US
Telephone Number	:	206-292-6488
Fax Number	:	206-623-2436

Provider Business Practice Location Address
First Line	:	1221 MADISON
Second Line	:	SUITE 1210
City	:	SEATTLE
State	:	WA
Zip	:	98104-1370
Country	:	US
Telephone Number	:	206-292-6488
Fax Number	:	206-623-2436

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/09/2006
Last Update Date	:	07/08/2007

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