MEDICARE: DR. HARRY COTLER DPM

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
1	213ES0103X	Foot & Ankle Surgery Podiatrist	01657	MD
2	213ES0131X	Foot Surgery Podiatrist	PO3942	FL
3	213ES0103X	Foot & Ankle Surgery Podiatrist	691	SC

General Provider Information

NPI Number	:	1730176249
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HARRY COTLER DPM

Provider Business Mailing Address
First Line	:	2287 HENRY TECKLENBURG DR
Second Line	:
City	:	CHARLESTON
State	:	SC
Zip	:	29414-7801
Country	:	US
Telephone Number	:	803-256-6776
Fax Number	:	803-256-6778

Provider Business Practice Location Address
First Line	:	1730 SAINT JULIAN PL
Second Line	:
City	:	COLUMBIA
State	:	SC
Zip	:	29204-2410
Country	:	US
Telephone Number	:	803-256-6776
Fax Number	:	803-256-6778

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/29/2005
Last Update Date	:	09/24/2020

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