MEDICARE: DR. OTTO R. DUENO M.D.

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	2084P0800X	Psychiatry Physician	35066509	OH

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	H069190	OTHER	OH	MEDICARE PTAN
3	PO1068644	OTHER	OH	MEDICARE RAILROAD

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

General Provider Information

NPI Number	:	1467447623
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. OTTO R. DUENO M.D.

Provider Business Mailing Address
First Line	:	1748 CEDAR RIDGE DR
Second Line	:
City	:	SPRING VALLEY
State	:	OH
Zip	:	45370-9783
Country	:	US
Telephone Number	:	937-848-3729
Fax Number	:

Provider Business Practice Location Address
First Line	:	1 ELIZABETH PL
Second Line	:	SUITE G-3
City	:	DAYTON
State	:	OH
Zip	:	45417-3445
Country	:	US
Telephone Number	:	937-281-0900
Fax Number	:	937-281-0930

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

Provider Enumeration Date	:	09/14/2005
Last Update Date	:	04/06/2022

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Directions to “ DR. OTTO R. DUENO M.D.” Practice Location

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