Provider Demographics
NPI:1669492641
Name:COTTER, MICHAEL BRIAN (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:BRIAN
Last Name:COTTER
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 1:6400 W NEWBERRY RD
Mailing Address - Street 2:SUITE 207
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32605-6605
Mailing Address - Country:US
Mailing Address - Phone:352-371-2011
Mailing Address - Fax:352-384-3611
Practice Address - Street 1:6400 W NEWBERRY RD
Practice Address - Street 2:STE 207
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32605-6605
Practice Address - Country:US
Practice Address - Phone:352-371-2011
Practice Address - Fax:352-384-3611
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-20
Last Update Date:2019-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0061235174400000X, 207V00000X
FLME61235207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL25070OtherBCBS
FL375062100Medicaid
FL102266OtherAVMED
FL102266OtherAVMED
FL25070YMedicare PIN