Individual
DR. DAVID R COTTAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1034 N 500 W, PROVO, UT 84604-3380
(801) 224-3555
Mailing address
560 W 800 N, OREM, UT 84057-3746
(801) 225-6246
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
6501499-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
107056147101
IHC
UT
01
—
35014991200001
BX
UT
05
—
870284448008
—
UT
01
—
870284448DCM
EMIA
UT
Enumeration date
05/03/2006
Last updated
01/24/2017
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