Individual
DR. CHARLES RAYMOND COTTRELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M D
Contact information
Practice address
2400 MICCOSUKEE RD, TALLAHASSEE, FL 32308-5314
(850) 205-8404
(850) 216-1321
Mailing address
2400 MICCOSUKEE RD, TALLAHASSEE, FL 32308-5314
(850) 205-8404
(850) 216-1321
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
ME34034
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
47488
BCBS PROVIDER NUMBER
FL
Enumeration date
07/26/2006
Last updated
07/08/2007
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