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General NPI Number Information
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NPI Number | 1174708622
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Entity Type | Individual
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Provider Name | PETER D COTEY D.O.
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Gender | Male
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Dates
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Enumeration Date | 01/03/2008
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Last Update Date | 02/20/2020
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Provider Practice Location Address
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Address Line | LANSING VA CBOC 2025 S WASHINGTON AVE
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City | LANSING
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State | MI
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Zip | 48910
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Country | US
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Telephone | 517-267-3925
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Fax | 517-267-3593
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Provider Business Mailing Address
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Address Line | 9424 W SCENIC LAKE DR
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City | LAINGSBURG
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State | MI
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Zip | 48848-9749
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Country | US
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Telephone | 517-651-1403
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Fax | 517-267-3593
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 5101011399
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License Number State | MI
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