Individual
DR. MARK CHRISTOPHER COTTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
100 PROFESSIONAL DR, REIDSVILLE, NC 27320-7173
(336) 342-3336
(336) 342-3226
Mailing address
8614 WESTWOOD CENTER DR FL 9, VIENNA, VA 22182-2442
(703) 847-8899
(703) 991-0514
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1411
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
011W8
BCBS GROUP #
NC
01
—
017NK
BCBS GROUP #
NC
01
—
0905F
BCBS PROV #
NC
01
—
09228
BCBS GROUP #
NC
01
—
246648I
MEDICARE GROUP #
NC
01
—
246648W
MEDICARE GROUP #
NC
01
—
7909228
MEDICAID GROUP #
NC
01
—
7909232
MEDICAID GROUP N#
NC
01
—
89011W8
MEDICAID GROUP #
NC
05
—
890905F
—
NC
01
—
8909406
MEDICAID GROUP #
NC
01
—
DD8241
RAILROAD MCARE GROUP #
NC
01
—
P00253796
RAILROAD MCARE PROV #
NC
Enumeration date
04/12/2006
Last updated
06/24/2024
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