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Individual
MICHAEL ROBERT OTT
Active
Individual
MICHAEL ROBERT OTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
200000925
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1266C
BCBS
NC
01
—
39-00201
UNITED HEALTHCARE
NC
05
—
891266C
—
NC
01
—
930102882
RAILROAD MEDICARE
NC
01
—
930104564
RAILROAD MEDICARE
NC
01
—
B4655
MEDCOST
NC
05
—
Q0092A
—
SC
Enumeration date
06/14/2005
Last updated
11/24/2009
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