Individual
MARILYN MARJORIE OTTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
5170 US RT 60 E, HUNTINGTON, WV 25705
(304) 528-4619
(304) 399-0133
Mailing address
5170 US RT 60 E, HUNTINGTON, WV 25705
(304) 528-4619
(304) 399-0133
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
17217
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0075595000
—
WV
05
—
0921471
—
OH
Enumeration date
06/10/2006
Last updated
02/19/2008
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