Healthcare Provider Details

I. General information

NPI: 1588727358
Provider Name (Legal Business Name): CHARLES MICHAEL COTTEN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/19/2006
Last Update Date: 06/22/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 ERWIN RD
DURHAM NC
27710-0001
US

IV. Provider business mailing address

2100 ERWIN RD DUKE UNIVERSITY MEDICAL CENTER - DUMC 2739
DURHAM NC
27710-0001
US

V. Phone/Fax

Practice location:
  • Phone: 919-620-4467
  • Fax:
Mailing address:
  • Phone: 919-681-4844
  • Fax: 919-681-6065

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License Number96-00035
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: