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General NPI Number Information
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NPI Number | 1760437107
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Entity Type | Individual
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Provider Name | TERI J COTTINGHAM M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/24/2006
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Last Update Date | 06/14/2011
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Provider Practice Location Address
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Address Line | 999 N CURTIS RD STE 505
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City | BOISE
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State | ID
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Zip | 83706-1336
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Country | US
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Telephone | 208-327-9521
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Fax | 208-327-9524
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Provider Business Mailing Address
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Address Line | 999 N CURTIS RD STE 505
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City | BOISE
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State | ID
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Zip | 83706-1336
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Country | US
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Telephone | 208-327-9521
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Fax | 208-327-9524
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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 | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | M7506
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License Number State | ID
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Taxonomy #2
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Taxonomy Code | 207ND0101X
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Taxonomy Name | MOHS-Micrographic Surgery Physician
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License Number | M-7506
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License Number State | ID
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Taxonomy #3
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Taxonomy Code | 207NS0135X
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Taxonomy Name | Procedural Dermatology Physician
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License Number | M-7506
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License Number State | ID
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