Provider Demographics
NPI:1346565157
Name:COTES, MAREN ELIZABETH SPECK (MD)
Entity Type:Individual
Prefix:DR
First Name:MAREN
Middle Name:ELIZABETH SPECK
Last Name:COTES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:MAREN
Other - Middle Name:ELIZABETH
Other - Last Name:SPECK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:4285 JOHNS CREEK PKWY
Mailing Address - Street 2:SUITE A
Mailing Address - City:SUWANEE
Mailing Address - State:GA
Mailing Address - Zip Code:30024-6038
Mailing Address - Country:US
Mailing Address - Phone:770-622-4412
Mailing Address - Fax:770-622-4191
Practice Address - Street 1:4285 JOHNS CREEK PKWY
Practice Address - Street 2:SUITE A
Practice Address - City:SUWANEE
Practice Address - State:GA
Practice Address - Zip Code:30024-6038
Practice Address - Country:US
Practice Address - Phone:770-622-4412
Practice Address - Fax:770-622-4191
Is Sole Proprietor?:No
Enumeration Date:2010-04-05
Last Update Date:2015-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA5119207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology