Individual
DR. GLENN MICHAEL KOTEEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2450 NE MARY ROSE PL STE 210, BEND, OR 97701-7133
(541) 728-0535
Mailing address
2450 NE MARY ROSE PL STE 210, BEND, OR 97701-7133
(541) 728-0535
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
022737
—
OR
Enumeration date
08/01/2006
Last updated
11/17/2008
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