Provider Demographics
NPI:1326003633
Name:COTANT, MICHAEL G (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:G
Last Name:COTANT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1021 PILGRIM AVE
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:MI
Mailing Address - Zip Code:48009-4612
Mailing Address - Country:US
Mailing Address - Phone:248-644-8637
Mailing Address - Fax:
Practice Address - Street 1:853 W WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:MARQUETTE
Practice Address - State:MI
Practice Address - Zip Code:49855-4139
Practice Address - Country:US
Practice Address - Phone:906-255-7918
Practice Address - Fax:906-225-8764
Is Sole Proprietor?:No
Enumeration Date:2006-04-19
Last Update Date:2023-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301052017208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIF27403OtherHAP
MI101488OtherPRIORITY HEALTH
MI340016376OtherRAILROAD MEDICARE
MI5258572OtherAETNA
MI0188330001OtherCIGNA
MI3406318292OtherHEALTH PLUS
MI5258572OtherAETNA
MI3406318292OtherHEALTH PLUS
MI0E06273017Medicare PIN