Healthcare Provider Details

I. General information

NPI: 1629065800
Provider Name (Legal Business Name): PEDRO J COTO M.D.M.P.H.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 10/03/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8450 DORSEY RUN RD
JESSUP MD
20794-9486
US

IV. Provider business mailing address

1133 PLEASANT VALLEY DR
BALTIMORE MD
21228-2644
US

V. Phone/Fax

Practice location:
  • Phone: 410-724-3082
  • Fax: 410-724-3079
Mailing address:
  • Phone: 410-788-4825
  • Fax: 410-724-3079

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License NumberD0016176
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: