Individual
DEAN OTTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
100 MEDICAL CAMPUS DR, LANSDALE, PA 19446-1259
(215) 361-4440
Mailing address
12265 TOWNSEND ROAD, PHILADELPHIA, PA 19154
(215) 856-1010
(215) 698-3730
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD058541-L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
960306
ABEM
—
01
—
MD058541-L
STATE LICENSE
PA
Enumeration date
10/04/2006
Last updated
03/07/2023
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