Healthcare Provider Details

I. General information

NPI: 1972769966
Provider Name (Legal Business Name): ROBERT NATHAN COTTERMAN D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/30/2008
Last Update Date: 11/03/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2109 HUGHES DR STE. 220
TOLEDO OH
43606-3856
US

IV. Provider business mailing address

2109 HUGHES DR STE. 220
TOLEDO OH
43606-3856
US

V. Phone/Fax

Practice location:
  • Phone: 419-291-5150
  • Fax: 419-479-6173
Mailing address:
  • Phone: 419-291-5150
  • Fax: 419-479-6173

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number34.010835
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code2086S0102X
TaxonomySurgical Critical Care Physician
License Number34.010835
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code2086S0127X
TaxonomyTrauma Surgery Physician
License Number34.010835
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: