Provider Demographics
NPI:1780849471
Name:COTTON, MICHAEL AARON (IDC)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:AARON
Last Name:COTTON
Suffix:
Gender:M
Credentials:IDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3259 CATLIN AVENUE
Mailing Address - Street 2:NAVAL HEALTH CLINIC
Mailing Address - City:QUANTICO
Mailing Address - State:VI
Mailing Address - Zip Code:22134-6050
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3259 CATLIN AVENUE
Practice Address - Street 2:NAVAL HEALTH CLINIC
Practice Address - City:QUANTICO
Practice Address - State:VI
Practice Address - Zip Code:22134-6050
Practice Address - Country:US
Practice Address - Phone:703-784-1725
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-23
Last Update Date:2008-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1002XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Corpsman