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NPI Code Detail

MEDICARE: GERTRUDE PO COTIAUX M.D.

MEDICARE: GERTRUDE PO COTIAUX M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician35-06-7352-COH
2207Q00000XFamily Medicine Physician39086SC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1376525667
Entity Type Code : Individual
Provider Name (Legal Business Name) : GERTRUDE PO COTIAUX M.D.
Provider Business Mailing Address
First Line : 1 INDEPENDENCE PT STE 212
Second Line :
City : GREENVILLE
State : SC
Zip : 29615-4536
Country : US
Telephone Number : 864-797-6306
Fax Number : 864-797-6306
Provider Business Practice Location Address
First Line : 2400 BOILING SPRINGS RD STE A
Second Line :
City : BOILING SPRINGS
State : SC
Zip : 29316-5304
Country : US
Telephone Number : 864-599-0731
Fax Number : 864-599-0791
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/14/2005
Last Update Date : 07/21/2022

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Directions to “ GERTRUDE PO COTIAUX M.D.” Practice Location

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