Individual
MRS. TAMARA O. COTTAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
820 E. 17TH STREET, CHEYENNE, WY 82001-4797
(307) 777-7911
(307) 634-3510
Mailing address
820 E. 18TH STREET, CHEYENNE, WY 82001-4797
(307) 777-7911
(307) 634-3510
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
5711A
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
111040300
—
WY
01
—
23042
DEPT. HEALTH HUMAN SVCS.
KS
01
—
313170
BLUE CROSS BLUE SHILED
WY
01
—
P00169593
RR MEDICARE
WY
Enumeration date
04/26/2006
Last updated
09/24/2013
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