| James Otto, M.d., P.a. | |
|
8835 Columbia 100 Parkway Suite N Columbia MD 21045-2147 | |
| (410) 997-0909 | |
| (410) 997-0504 |
| Full Name | James Otto, M.d., P.a. |
|---|---|
| Speciality | Internal Medicine |
| Location | 8835 Columbia 100 Parkway, Columbia, Maryland |
| Authorized Official Name and Position | Ellen Hagen (BILLING MANAGER) |
| Authorized Official Contact | 4102032882 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| James Otto, M.d., P.a. 3734 Garand Rd. Ellicott City MD 21042 Ph: (410) 465-6186 | James Otto, M.d., P.a. 8835 Columbia 100 Parkway Suite N Columbia MD 21045-2147 Ph: (410) 997-0909 |
| NPI Number | 1730378142 |
|---|---|
| Provider Enumeration Date | 10/22/2007 |
| Last Update Date | 11/19/2007 |
| Medicare PECOS PAC ID | 0840280921 |
|---|---|
| Medicare Enrollment ID | O20040512001520 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730378142 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | D39178 (Maryland) | Primary |
| Provider Name | James Otto |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1356317259 PECOS PAC ID: 9830189919 Enrollment ID: I20040517000627 |
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