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Individual
DR. RICHARD OTTO
Active
Individual
DR. RICHARD OTTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
079294
GA
208800000X
Urology Physician
Primary
75503
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100176271
—
WI
Enumeration date
05/09/2012
Last updated
07/29/2024
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