Provider Demographics
NPI:1588815310
Name:SZIMA-COTTER, PETRONELA (PA-C)
Entity type:Individual
Prefix:
First Name:PETRONELA
Middle Name:
Last Name:SZIMA-COTTER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:PETRONELA
Other - Middle Name:
Other - Last Name:SZIMA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:600 N WOLFE ST
Mailing Address - Street 2:JHH UROLOGY DEPARTMENT
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21287-0005
Mailing Address - Country:US
Mailing Address - Phone:410-955-4494
Mailing Address - Fax:410-614-3695
Practice Address - Street 1:600 N WOLFE ST
Practice Address - Street 2:JHH UROLOGY DEPARTMENT
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21287-0005
Practice Address - Country:US
Practice Address - Phone:410-955-4494
Practice Address - Fax:410-614-3695
Is Sole Proprietor?:No
Enumeration Date:2008-10-10
Last Update Date:2008-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDC03899363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant