Provider Demographics
NPI:1235373424
Name:COTHERN, MICHAEL EUGENE (PA-C)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:EUGENE
Last Name:COTHERN
Suffix:
Gender:M
Credentials:PA-C
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Mailing Address - Street 1:81 HIGHLAND AVE, NORTH SHORE MEDICAL CENTER
Mailing Address - Street 2:CARDIAC CATHETERIZATION LAB, PHIPPEN 5
Mailing Address - City:SALEM
Mailing Address - State:MA
Mailing Address - Zip Code:01970
Mailing Address - Country:US
Mailing Address - Phone:978-354-4494
Mailing Address - Fax:978-740-4804
Practice Address - Street 1:81 HIGHLAND AVE
Practice Address - Street 2:CARDIAC CATHETERIZATION LAB, PHIPPEN 5
Practice Address - City:SALEM
Practice Address - State:MA
Practice Address - Zip Code:01970-2714
Practice Address - Country:US
Practice Address - Phone:978-354-4494
Practice Address - Fax:978-740-4804
Is Sole Proprietor?:No
Enumeration Date:2009-05-01
Last Update Date:2009-05-01
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Provider Licenses
StateLicense IDTaxonomies
MA670363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant