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General NPI Number Information
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NPI Number | 1730378142
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Entity Type | Organization
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Legal Business Name | JAMES OTTO, M.D., P.A.
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Dates
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Enumeration Date | 10/22/2007
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Last Update Date | 11/19/2007
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Provider Practice Location Address
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Address Line | 8835 COLUMBIA 100 PARKWAY SUITE N
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City | COLUMBIA
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State | MD
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Zip | 21045-2147
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Country | US
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Telephone | 410-997-0909
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Fax | 410-997-0504
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Provider Business Mailing Address
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Address Line | 3734 GARAND RD.
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City | ELLICOTT CITY
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State | MD
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Zip | 21042
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Country | US
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Telephone | 410-465-6186
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Fax |
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Authorized Official
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Title or Position | BILLING MANAGER
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Name | ELLEN HAGEN
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Credential |
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Telephone | 410-203-2882
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | D39178
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License Number State | MD
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