Individual
DR. RAYMOND J OTTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
600 ROBBINS RD, BOISE, ID 83702
(208) 489-5800
Mailing address
PO BOX 165, BOISE, ID 83701-0165
(208) 489-5800
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
M-9590
ID
207PE0005X
Undersea and Hyperbaric Medicine (Emergency Medicine) Physician
Primary
M-9590
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
807447900
—
ID
Enumeration date
06/14/2006
Last updated
08/03/2018
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