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General NPI Number Information
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NPI Number | 1538568696
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Entity Type | Organization
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Legal Business Name | JAMES COTICCHIA, M.D., P.C.
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Dates
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Enumeration Date | 08/14/2014
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Last Update Date | 05/29/2015
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Provider Practice Location Address
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Address Line | 18181 OAKWOOD BLVD STE 202
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City | DEARBORN
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State | MI
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Zip | 48124-4082
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Country | US
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Telephone | 248-652-2240
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Fax | 248-659-1861
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Provider Business Mailing Address
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Address Line | 18181 OAKWOOD BLVD STE 202
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City | DEARBORN
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State | MI
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Zip | 48124-4082
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Country | US
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Telephone | 248-652-2240
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Fax | 248-659-1861
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Authorized Official
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Title or Position | PRESIDENT
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Name | JAMES COTICCHIA
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Credential |
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Telephone | 248-652-2240
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207YP0228X
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Taxonomy Name | Pediatric Otolaryngology Physician
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License Number | 4301082703
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License Number State | MI
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