Provider Demographics
NPI:1043322746
Name:COTTMAN, MARIE A (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:MARIE
Middle Name:A
Last Name:COTTMAN
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:312 LINCOLN CTR
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95207-2627
Mailing Address - Country:US
Mailing Address - Phone:209-474-7271
Mailing Address - Fax:209-474-7168
Practice Address - Street 1:312 LINCOLN CTR
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95207-2627
Practice Address - Country:US
Practice Address - Phone:209-474-7271
Practice Address - Fax:209-474-7168
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2008-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA50142183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist