Healthcare Provider Details

I. General information

NPI: 1457933293
Provider Name (Legal Business Name): YVONNE CHRISTINE COTTERELL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/21/2021
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date: 04/21/2021
Reactivation Date: 06/25/2021

III. Provider practice location address

345 SAINT PAUL ST
BALTIMORE MD
21202-2123
US

IV. Provider business mailing address

345 SAINT PAUL ST
BALTIMORE MD
21202-2123
US

V. Phone/Fax

Practice location:
  • Phone: 410-332-9055
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License NumberD0107720
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: