Healthcare Provider Details

I. General information

NPI: 1386689305
Provider Name (Legal Business Name): ROBERT W OTTE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2006
Last Update Date: 11/03/2020
Certification Date: 11/03/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

310 RODI RD SUITE 160
PITTSBURGH PA
15235-3318
US

IV. Provider business mailing address

3824 NORTHERN PIKE SUITE 700
MONROEVILLE PA
15146-2141
US

V. Phone/Fax

Practice location:
  • Phone: 412-243-1945
  • Fax: 412-243-1947
Mailing address:
  • Phone: 412-457-0060
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License NumberMD037327E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: