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Individual
MICHAEL WOOTTEN
Active
Individual
MICHAEL WOOTTEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
30205
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01-12683
MEDICA - PRIMARY
MN
01
—
0190027
PREFERREDONE
MN
01
—
059550
FAIRVIEW
MN
01
—
109253
UCARE
MN
01
—
36A76WO
BLUE CROSS BLUE SHIELD
MN
01
—
768417
ARAZ
MN
01
—
HP27070
HEALTHPARTNERS
MN
Enumeration date
10/04/2006
Last updated
04/23/2012
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