Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0003X | Hematology & Oncology | 4301077875 | MI |
NPI | 1003930215 |
---|---|
Provider Name | Dr. Matthew Burns Cotant |
First Address | Royal Oak, MI 48073-6710 |
Second Address | Royal Oak, MI 48073-6710 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/03/2007 |
Last Update Date | 22/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
4301077875 | PHYSICIAN LICENSE (01) | MI |