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General NPI Number Information
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NPI Number | 1740271493
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Entity Type | Individual
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Provider Name | DANIEL P OTCHY M.D.
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Gender | Male
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Dates
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Enumeration Date | 11/02/2005
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Last Update Date | 03/01/2018
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Provider Practice Location Address
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Address Line | 2710 PROPERSITY AVENUE 200
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City | FAIRFAX
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State | VA
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Zip | 22031
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Country | US
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Telephone | 703-280-2841
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Fax | 703-280-4773
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Provider Business Mailing Address
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Address Line | 2710 PROPERSITY AVENUE 200
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City | FAIRFAX
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State | VA
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Zip | 22031
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Country | US
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Telephone | 703-280-2841
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Fax | 703-280-4773
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208C00000X
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Taxonomy Name | Colon & Rectal Surgery Physician
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License Number | 0101230552
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 0101230552
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License Number State | VA
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