Provider Demographics
NPI:1730280694
Name:COTES, OSTERMAN (MD)
Entity Type:Individual
Prefix:DR
First Name:OSTERMAN
Middle Name:
Last Name:COTES
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 1:500 POPLAR ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SOUTH CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25309-1474
Mailing Address - Country:US
Mailing Address - Phone:304-766-3400
Mailing Address - Fax:304-766-3499
Practice Address - Street 1:500 POPLAR STREET
Practice Address - Street 2:SUITE 200
Practice Address - City:SOUTH CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25309-1474
Practice Address - Country:US
Practice Address - Phone:304-766-3400
Practice Address - Fax:304-766-3499
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-25
Last Update Date:2011-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV09983-WV174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist