Provider Demographics
NPI:1275597445
Name:COTTERELL, GREGORY FRANCIS (MD)
Entity Type:Individual
Prefix:
First Name:GREGORY
Middle Name:FRANCIS
Last Name:COTTERELL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 43
Mailing Address - Street 2:MR 10809
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55440-0043
Mailing Address - Country:US
Mailing Address - Phone:612-262-4813
Mailing Address - Fax:612-262-4194
Practice Address - Street 1:360 SHERMAN ST
Practice Address - Street 2:160
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55102-2564
Practice Address - Country:US
Practice Address - Phone:651-251-7200
Practice Address - Fax:651-241-7210
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-14
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
MN27826207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
B58627Medicare UPIN