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1306828413

NPI Code Detail

MEDICARE: CHRISTOPHER E OTT MD

MEDICARE: CHRISTOPHER E OTT MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	48815	WI

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	P00152829	OTHER	WI	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	390807236CQ	OTHER	WI	UNITY
3	WI01R8	OTHER	WI	JOHN DEERE
5	13783	OTHER	WI	DEAN
6	392787907005	OTHER	WI	BLUE CROSS

General Provider Information

NPI Number	:	1306828413
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTOPHER E OTT MD

Provider Business Mailing Address
First Line	:	2603 WHITE BEAR AVE N
Second Line	:
City	:	MAPLEWOOD
State	:	MN
Zip	:	55109-5110
Country	:	US
Telephone Number	:	651-600-3035
Fax Number	:	651-348-8783

Provider Business Practice Location Address
First Line	:	2603 WHITE BEAR AVE N
Second Line	:
City	:	MAPLEWOOD
State	:	MN
Zip	:	55109-5110
Country	:	US
Telephone Number	:	651-600-3035
Fax Number	:	651-348-8783

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/15/2005
Last Update Date	:	06/23/2020

Similar Medicare Providers

1174593990 — THERESA M HOFFOSS WHCNP
Practice Location Address:

2603 WHITE BEAR AVE N
MAPLEWOOD, MN
55109-5110

Practice Phone: 651-600-3035
Practice Fax: 651-348-8783

1881663789 — JULIE ANN VINGERS CNM
Practice Location Address:

2603 WHITE BEAR AVE N
MAPLEWOOD, MN
55109-5110

Practice Phone: 651-600-3035
Practice Fax: 651-348-8783

1750311320 — DONNA D RANDALL MD
Practice Location Address:

2603 WHITE BEAR AVE N
MAPLEWOOD, MN
55109-5110

Practice Phone: 651-600-3035
Practice Fax:

1003839853 — LAURE JO WASCHBUSCH MD
Practice Location Address:

2603 WHITE BEAR AVE N
MAPLEWOOD, MN
55109-5110

Practice Phone: 651-600-3035
Practice Fax:

1548353469 — COREEN S SMITH CNP, MS
Practice Location Address:

2603 WHITE BEAR AVE N
MAPLEWOOD, MN
55109-5110

Practice Phone: 651-600-3035
Practice Fax: 651-348-8783

1578608055 — DEANNA LYNN FRANCIS MS RD LD CDE
Practice Location Address:

2603 WHITE BEAR AVE N
MAPLEWOOD, MN
55109-5110

Practice Phone: 651-600-3035
Practice Fax: 651-348-8783

Directions to “ CHRISTOPHER E OTT MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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